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Making Waves

Friday March 26, 2010
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Meditation — long considered by many the province of Buddhists and New Age gurus — is gaining new respect among neurologists, psychiatrists and others who study the brain. An increasing volume of scientific study is not only showing that meditation helps reduce stress, but is offering some physiological clues about why it might be beneficial to the body and brain.

Meditation has been studied for 20 years, but in the past five to 10 years the focus of that research has gone beyond the idea that meditation makes a person feel better to scientific measurement of physiological changes, says Susan Bauer-Wu, RN, PhD, FAAN, a cancer researcher and associate professor of nursing at Emory University in Atlanta.

Recent studies of mindfulness meditation have shown evidence it may bolster the immune system and slow the progression of disease in patients with HIV/AIDS, improve blood pressure and reduce psychological distress in young adults, improve the emotional well-being and mental health of breast cancer patients, and be as effective as medications in treating insomnia.

Bauer-Wu sees a future where nurses receive mindfulness training just as they now learn to assess pain or insert an IV, and have it in their arsenal to help themselves and their patients. “Medications don’t change your life,” Bauer-Wu says. “Meditation doesn’t change your life, either. But mindfulness meditation can change your responses to everyday challenges. It gives you a skill that you can use in all aspects of your life.”

Neuroplasticity

The most recent — and for some researchers the most exciting — studies have shown how meditation affects the brain itself, acting on regions to help suppress fear or anxiety, or stimulating those that involve compassion. Researchers are especially interested in “neuroplasticity,” the idea that the entire brain changes and develops over time, creating new neural pathways in response to outside stimulation rather than remaining fixed in certain regions since early childhood, as previously thought.

Recent work by Richard J. Davidson, PhD, neuroscientist at the University of Wisconsin at Madison, has examined the brain activity of Tibetan monks who practice compassion meditation. His studies found they produced more powerful and more organized movement of gamma waves — some of the highest frequency brain waves — than inexperienced volunteers who also meditated. The intense gamma waves are associated with connecting different brain circuits, producing higher mental activity and heightened awareness. Davidson also found the monks’ brain activity was especially high in the region of the prefrontal associated with empathy, and positive thoughts and emotions.

Other studies have shown activity in specific areas of the brain in practitioners of mindfulness-based stress reduction, a program based on Buddhist-style practices notably touted by Jon Kabat-Zinn, PhD, a microbiologist and professor emeritus at the University of Massachusetts Medical Center.

In studies by Matthew D. Lieberman, PhD, a UCLA associate professor of psychology, brain scans have shown that labeling emotions, which is part of mindfulness meditation, seems to produce more activity in an area of the prefrontal cortex that turns down emotional response, and decreased activityin the amygdala, the brain’s alarm system, which triggers fear, angerand distress.

“Mindfulness is a natural, basic science,” says Daniel J. Siegel, MD,an associate clinical professor of psychiatry and researcher at the UCLA School of Medicine, and executive director of the Mindsight Institute in Southern California. “It does not just reduce stress; it has now been shown to be crucial to your ability to promote the growth of your mind.”

An initial three minutes of focused breathing a day works the way a walk around the block might for a couch potato, Siegel says. Eventually practitioners build up their ability to meditate for longer periods of time, and to calm themselves more easily in stressful situations. “You actually change the regulatory circuits in the brain,” he says.

Research Reveals Benefits

Bauer-Wu is finishing a large multi-site study of the effects of meditation on stress levels and coping skills of people receiving stem-cell bone marrow transplants in Massachusetts and Georgia. Data for the large study are still being analyzed, Bauer-Wu says. But results from a pilot showed significant benefits for patients who received meditation training, including lowered heart and respiratory rates, lower levels of stress hormones, decreased need for antibiotics and pain medications, shorter length of stay in the hospital, and self-reported decreases in pain, nausea, depression and anxiety.

Other studies are examining the effect of mindfulness meditation on nurses and their practices. At the Mayo Clinic in Scottsdale, Ariz., Teri Britt Pipe, RN, PhD, director of nursing research and innovation, conducted a study on nurse leaders who attended four weeks of mindfulness meditation classes and practiced meditation regularly.

“We found significant decreases in stress, depression and anxiety,” Britt Pipe says, both compared to a control group and in a before-and-after measurement of the study group. Cortisol, a hormone involved in stress, returned to normal in some people whose levels had indicated chronic stress before the meditation sessions, she says.

In a similar study of staff nurses at Brigham and Women’s Hospital in Massachusetts, those who took classes and practiced meditation reported statistically significant levels of reduced stress, both in their professional and personal lives, than a control group, says Carolyn Hayes, RN, PhD, NEA-BC, director of oncology nursing and clinical services.

Mary Jane Ott, MN, MA, APRN, BC, RYT, is a clinical nurse specialist in integrative therapies at Leonard P. Zakim Center for Integrative Therapies, part of the Dana-Farber Cancer Institute in Massachusetts. For years she has practiced meditation in her personal and professional life, and observed how it relieves pain.

“Most of us immediately tense up when we experience pain,” Ott says. People try to escape the sensation, they recall past pain or they fear the pain will not go away. Mindfulness meditation has them focus on the pain, searching for where it is in the body, without relating it to what has happened or what might happen.

“Part of the beauty of mindfulness meditation is it can be used from a secular approach, across the cultural, religious and spiritual spectrum.”


Cathryn Domrose is a staff writer for Nurse.com.Editor's Note: Take our CE module, “Research Reveals the Benefits of Meditation” at www.ce.nurse.com/CE385-60 or register for our two-retreat Meditation Specialist Certification seminar at www.nurse.com/events.Send a letter to editorNTL@gannetthg.com or post a comment below.
What Is Meditation?

Most forms of meditation help practitioners focus their attention and become more aware of their thoughts, feelings and sensations by observing things without judging them. Many meditation practitioners and teachers recommend starting with three to five minutes a day and building up to at least 20 minutes.

Regular practice of most types of meditation usually requires a quiet location; a specific, comfortable posture (lying, sitting, standing or walking); a focus of attention, such as the sensation of breathing or a word or phrase; and an open attitude, allowing thoughts to come and go naturally.

Some types of meditation include:

Mindfulness meditation, also called mindfulness stress reduction. The focus is on breathing, letting thoughts come and go, but always directing attention back to the breath. The idea is to develop an increased awareness of being mindful and living in the present moment, whether in breathing, eating, walking or doing yoga.

Compassion meditation. Instead of on breathing, the focus is on a cause, another person or all sentient beings. Often the practitioner repeats a word, thought or phrase such as, “May my family be free from suffering,” or “May the world be at peace.”
Qigong (chee-kung). Part of traditional Chinese medicine, qigong combines meditation, slow physical movement, balance and breathing exercises with the object of strengthening the body and relaxing the mind.

Tai chi. A form of Chinese martial art, tai chi involves a self-paced series of postures or movements that accompany practiced deep breathing.

Yoga. A series of postures, stretches and controlled breathing exercises promote flexibility, strength and a calm mind. By concentrating on postures that require balance and concentration, practitioners focus on being in the moment.