20 September 2021

In praise of mentors – and a tribute to a footballing legend

There are many things to adapt to as one becomes older. Speaking personally, one surprise has been the size of the hole left by outliving significant elders. However, with the losses has come an even greater appreciation for the genuine mentors who have blessed, informed and enriched my life in so many ways. 

With my AFL football team - Melbourne - a real prospect to win its first Grand Final in 57 years, it feels appropriate to share something of the remarkable life of a Club legend who was a mentor, and to enthuse about seeking out and maintaining relationships with mentors if you do not have them already, but first

     Thought for the Day


The Buddha is not going to project you to Buddhahood, 

As if throwing a stone. 

He is not going to purify you, 

As if washing a dirty cloth, 

Nor is he going to cure you of ignorance, 

Like a doctor administering medicine to a passive patient. 

Having attained full enlightenment himself, 

He is showing you the path, 

And it is up to you to follow it or not. 

It is up to you now 

To practice these teachings 

And experience their results.

                Dilgo Khyentse Rinpoche


Close friend of my father, Godfather to my elder sister, father of 2 sons I attended school with and one daughter, local doctor in outer Melbourne at the one family practice for life, footballer, incredibly decent human being and powerful influence in my own life for good – Dr Donald Cordner. 

Our families grew up together and we visited regularly. But imagine this – it speaks to the modesty of the man – not until around the age of 30 did I come to know Donald had won a Brownlow Medal in 1946 (best and fairest in the competition) and that he served on the Melbourne Football Club’s Board and as President of the Melbourne Cricket Club. He never spoke of his considerable accomplishments.

Also, for those who watched the pageant and tasteful ceremony of this year's Brownlow presentation as a major event on television, consider this. In 1946, Donald was advised by mail he had won the Brownlow. He was summoned to a Board meeting at VFL House (it was V for Victoria in those days not Australian FL) where he waited half an hour on his own in an ante room. The Chair then said "Player Cordner, you have been awarded this year's Brownlow Medal", handed over the medal, shook his hand and sent him on his way. No media, no fuss; that was it!

As a teenager whose mother had died at 12, Donald was a point of reference. Whenever we visited, whenever we met, he greeted me with warm-hearted affection and importantly, with interest. He always took time to enquire what was happening in my life and was full of encouragement for whatever interested me. He was always asking challenging, sometimes provocative questions; stimulating analysis and reflection. One of his habits was to throw puzzles at his children and their visitors; he was fun as well as comforting. 

Along with his equally remarkable wife, Moyle (from whose presence I also derived great benefit) Donald provided a real model of what a long-term successful marriage could look like.

When my cancer appeared in 1975, my father was living overseas. It was Donald who came to the Hospital and helped arrange the best care and steer me through the difficult choices that led to my leg being amputated. Again, his inner strength and calm was steadying.

As the years went on and my work shifted from the veterinary world towards that of medicine, Donald was happy to discuss issues and provide insight. From time to time we would meet at the MCG, discuss the footy, usually lament the parlous state of Melbourne’s performances, touch on the news of the day, the progress in my life and work. Those meetings were always like a tonic.


Sadly, Donald died in 2009 aged 87.

With Melbourne playing in the 2021 Grand Final, 

Donald would be thrilled. 

I think of him and feel so fortunate to have had this man in my life.


The message? 


Mentors play a key role in life. Elders are important and warrant close relationships, but mentors go to the next level. Some mentors drop into your lap, some you need to seek out. Either way, whether young or older, make the effort; actively build a relationship with one or preferably more mentors. And as you advance in age, experience and wisdom, consider who you might be able to mentor. Pay it forward…


       And of course 


            - Melbourne for premiers!!!





06 September 2021

COVID, antivaxxers and tolerance – breaking the silence

This is a blog about tolerance and what sort of society we all want to live in. No doubt we all want peace and harmony, but is that because we want everyone to agree with us and be like us? Or because we encourage diversity and make an effort to understand, tolerate and even welcome it?

Currently, medical and media opinions are vehemently pro-vaccination. In my opinion they have good grounds for this stance, yet I am disturbed by how many seem intent on ridiculing and shaming those opposed – the antivaxxers, even those slow on the uptake. This tends to polarise people, create entrenched defensive/aggressive positions, take people to extremes and create what is now close to a taboo around even discussing the topic. 

The last blog on vaccinations stirred a good deal of response, including an old friend who shared their own diary-like writings aimed at helping clarify their decision not to be vaccinated at this point in time.

Choosing not to be vaccinated for COVID seems somewhat perilous. No doubt there are many reasons people chose not to be vaccinated, yet currently it seems very difficult to have a measured conversation about why. Tolerance may be in short supply.

Clearly the conclusions this friend has come to are not the same as mine, however, they are well thought out, clearly expressed, may surprise you, and warrant consideration and understanding. 

So how do you respond to someone who has a strongly opposed view to your own? Who is different to you? Is there any curiosity to attempt to understand them? Their point of view? Or is there a rapid and emotion move towards derision? Do you consider yourself to be tolerant, but then feel free to be hard on anti-vaxxers and those who support Trump – as examples of exceptions we all might hold to…

In the interest of being open and of breaking any potential silence or taboo; in the interest of challenging tolerance and commitments to understanding, here are my friend’s reflections, but first



   Thought for the day

 Ultimately, happiness comes down to choosing between 

 The discomfort of becoming aware of your mental afflictions 

 And the discomfort of being ruled by them.

                             Mingyur Rinpoche





Reflections from a friend   who asked to remain anonymous - a further indication of the difficulty expressing these views publicly…

In January this year I reviewed my position re COVID vaccinations and came to the position that I would not get vaccinated but that I would leave the door open and see how the situation unfolds. Time has moved on and a new situation presents itself. I feel it time to review my position.

What is new? We now have ready availability of vaccines and subsequent pressure from the government and media for people to get vaccinated.

Also, potentially severe restrictions are emerging for non-vaccinated people. 

This includes likely expected pressure and victimisation of non-vaccinated people from the wider public. 

My expectation is that life will become very difficult and restricted for non-vaccinated people.

How does this influence my position re COVID vaccination? 

On the one hand it would be so easy to just give in, make an appointment and have this vaccination over and done with and life could continue as usual – fairly straightforward. In addition to that I could do a bit more specific healing meditation around the actual vaccination event and the impact on the body, as a friend of mine suggests and ‘end-of-story’. Let life go on without avoidable government pressure/punishment and potentially ugly peer pressure and the fear surrounding all of that. 

So what is holding me back from this fairly straightforward process?

There is a strong inner voice active in me telling me to not accept this vaccination for myself. 

The inner voice is based on the following points:

1. I have reservations about the lack of a spiritual awareness in mainstream science and in medicine particularly. The human body is commonly regarded as a ‘complicated machine’ devoid of a spiritual dimension. In my worldview there are 2 vital dimensions - spirit and matter. For me, very clearly spirit is primary and matter secondary. 

From that perspective I evaluate very carefully what allopathic/mainstream medicine offerings are acceptable to me or not. In case of COVID vaccination; that is not acceptable to me at this point in time.

2. I am very particular about what I accept going into my body or being done to my body in the form of drugs, vaccines, medical treatments and foods. There is a particular emphasis for me to avoid genetically engineered/manipulated DNA substances wherever possible.

3. I maintain a healthy immune system through a very healthy lifestyle and I trust my immune system to be able to handle viruses.

4. I am not afraid of death. I accept my destiny. If I get COVID or other viruses I will do my best to recover from it. However, if it is my destiny to die from a viral infection, so be it.

5. In the mainstream narrative of the so-called COVID pandemic, the COVID virus is seen as the primary enemy and warlike measures have unfolded worldwide to ‘beat the enemy’. 

Following explanations of credible virology experts in the field there are millions of different viruses around and we could not exist without the viral dimension. 

The challenge is to find a way to co-exist with the viruses and on one level strengthen the immune system to cope with the health effects of some viruses like COVID. 

On another level there needs to be a clearer recognition how the treatment and exploitation of the earth, animals and plants as spirit-less commodities has contributed to conditions whereby viruses jump from animals to humans for instance and interfere with human health. I suggest the root causes should be addressed as a matter of urgency to work towards a sustainable future for all living beings.

6. I spent a lot of time reading/listening/watching the ‘experts’ in the field arguing for and against the current COVID vaccinations and the severity of the so-called COVID pandemic over the last 18 months. I cannot claim to know the truth; as a matter of fact I realised that no amount of research will lead me to the point of ‘knowing the truth’. However, all the information I could take in from the experts in the fields from different camps, leaves me with serious question marks over the validity, accuracy, robustness of the ‘main narrative’ promoted relentlessly by the so-called mainstream leading medical organisations, the mainstream media and the governments at all levels. 

For me the ‘mainstream narrative’ leaves me with too much doubt, too many question marks. And for me this puts serious reservations over the real motives for the relentless, unprecedented push for people to get vaccinated. Too much doubt remains for me which prevents me from trusting the ‘main narrative’. Based on all that I cannot just take the simple way out and get vaccinated. 

The opposition of my ‘inner voice’ to the COVID vaccinations for myself is also strongly linked to my
spiritual beliefs. 

It feels that I am at a major inner crossroad with the vaccination question with potentially serious long term consequences one way or the other. 

Of greatest importance for me at this crossroad is to make my decision based on a state of spiritual ‘Presence’. 

To avoid making decisions based on fear or hatred or anger or ‘becoming a martyr’ which would be related to my ‘pain body’ and driven by my ‘lower ego’. Instead I want to make my crucial decision out of freedom, guided by my ‘I am’, the ‘Deep I’.

The best I can do at this very moment is to listen to my ‘inner voice’ to the best of my capability. This voice is clear for me at the moment and that is to not take the vaccinations at this point in time. 

My firm intention is to do my best to be able to look into the future without fear and anxiety and to strive to have complete peace of soul and tranquillity of mind. And in the given moment to hopefully be able to make decisions out of full ‘Presence’.

I strongly believe in basic ‘human rights’ and one of the most fundamental human right for me is that of ‘informed consent’. At this stage I clearly do not consent to the COVID vaccination.

I fully respect the rights of other people including friends, partner, family members, colleagues to arrive at
their own decision re the COVID vaccination and I respect their choices. 

I also accept my responsibility towards the health of fellow human beings and I will apply appropriate self-isolation measures if I ever do show any relevant symptoms.


RELATED BLOG

How to have a COVID vaccine that is effective and side-effect free






23 August 2021

How to have a COVID vaccination that is side-effect free and effective

Don’t you just love a good coincidence. Recently had my first COVID vaccine - Pfizer variety – and no side effects. This “coincided” with doing a series of simple mind exercises that all you meditators would relate to easily – and may find helpful.

So having resisted writing about vaccines to date, this week, what are the side-effects, how often do they occur and how might you minimise them; and a special point - are symptoms necessary to achieve good levels of immunity? 

Maybe if you or someone you care for is still to be vaccinated you can experience it symptom free and effective, but first 

     Thought for the day

Our problems, both personal and global, seem so complicated, 

And at an intellectual level, they are. 

But the real root of our problems lies at a different level, 

Simpler but more intractable 

– in our anger, self-interest, fear, greed 

– and only at that deeper level can real transformation occur. 

We can think up clever policies and make grand pronouncements, 

But if in our hearts we are really not moved by the suffering of others, 

Then nothing will really change.




Simply put, real change happens in the heart, 

And there the future of our world will be decided. 

                   HH The Dalai Lama


Please be clear, what follows is not a PhD, rather my own summarised investigations. Reference articles have direct links to the original papers.

Everyone is encouraged to make further investigations themselves and consult your doctors when making medical decisions.


WHAT ARE THE COVID VACCINE SIDE-EFFECTS and HOW OFTEN DO THEY OCCUR?

1. Pfizer has less side-effects than AstraZeneca according to The Lancet.

Vaccine side-effects and SARS-CoV-2 infection after vaccination in users of the COVID Symptom Study app in the UK: a prospective observational study. 

Menni C et al. The Lancet, 2021: Vol 21, issue 7, P939-949.

2. What are Pfizer’s side effects?

In this study of Healthcare Workers - who were regarded as highly likely to provide accurate feedback - injection site pain was recorded by 89.8%, fatigue 62.2%, headache 45.6%, muscle pain 37.1%, and chills 33.9%. 

Thirteen percent reported at least one oral side effect; the most common of which was blisters (36%), followed by halitosis (25.4%), ulcers (14%), bleeding gingiva (11.4%), and white/red plaque (10.5%).

All the general side effects were more prevalent among those under 43 years old.


3. How long do Pfizer side-effects last?

The study found 45.1% of the above symptoms lasted for 1 day, while 35.8% lasted for 3 days, 9.4% lasted for 5 days, 5.3% lasted for one week, 3% lasted for over a week, and 1.4% for over a month. 

Riad A et al. Prevalence of COVID-19 Vaccine Side Effects among Healthcare Workers in the Czech Republic. J Clin Med. 2021;10(7):1428. Published 2021 Apr 1. doi:10.3390/jcm10071428


4.What about severe side effects?

Side effects that required medical intervention were reported by only 1.3% of this study group (not sure if this number may have been somewhat reduced as this was a group of health workers and they may have self-treated; but anyway, severe side-effects can be taken to be small). 

Elsewhere, The European Medicines Agency has estimated that the risk of cerebral venous thrombosis after the AstraZeneca vaccine is 5.0 (4.3 to 5.8) per million people. Evaluating the risk of thrombosis in Pfizer is not easy, but seems less than AstraZeneca, while the risk of myocarditis or other major heart issues is real but rare and still being clarified.

DO YOU NEED TO GET SIDE-EFFECTS FOR THE VACCINE TO WORK?

There seems to be a popular myth that greater side-effects indicate a greater immune response from your body and hence, point to better protection.

Happily, the evidence does not support this. In fact, the evidence indicates the level of immunity is relatively independent of the level of side-effects according to research published in JAMA Internal Medicine. “Overall, the findings suggest that regardless of vaccine reactions or prior SARS-CoV-2 infection, either spike mRNA vaccine will provide a robust spike antibody response.”

Debes AK, Xiao S, Colantuoni E, et al. Association of Vaccine Type and Prior SARS-CoV-2 Infection With Symptoms and Antibody Measurements Following Vaccination Among Health Care Workers. JAMA Intern Med. Published online August 16, 2021. doi:10.1001/jamainternmed.2021.4580

So it seems OK to do what you can to minimise or avoid side-effects altogether.

SO WHY GET VACCINATED NOW?

Put simply, the vaccines work, the side-effects are now shown to be minimal and my guess is it will not be long before the unvaccinated will be restricted in what they can access.

While thorough research is yet to be published, a Public Health England analysis (in a preprint that has not yet been peer-reviewed) showed at least two vaccines to be effective against Delta. 

The Pfizer-BioNTech vaccine was 88% effective against symptomatic disease and 96% effective against Delta, while Oxford-AstraZeneca was 60% effective against symptomatic disease and 93% effective against hospitalization. 

The studies tracked participants who were fully vaccinated with both recommended doses.

It seems for the maximum protection from a two-dose vaccine like Pfizer, you must get both shots and then wait the recommended two-week period for those shots to take full effect.

MAYBE SOME PERSONAL CONTEXT IS USEFUL 

When the COVID vaccines first appeared, they did come as a triumph of modern medicine and science. However, they did come with new technology; they inject mRNA and DNA that tricks our immune system into thinking it is being invaded by the actual virus; and causes it to mount an immunological reaction to it.

Given Australia had low rates of infection when the vaccines first appeared, I felt happy to wait and see if this new vaccination method had any unforeseen side-effects. 

Normally, most vaccine side-effects surface within a few months of introduction – to date there has not been an exception to this that I know of; particularly when millions are receiving the vaccines. 

So the risk of significant side-effects years down the track feels pretty remote to me. The evidence for this is pretty solid.

But then came the Delta variant, infections broke out again and it is becoming clear the chance of returning to zero cases is slim; not impossible, but slim. 

Also, even with 80% vaccination rates there will still be significant Delta outbreaks, and the likelihood of needing vaccination to travel and go to major events is highly probable. 

Not to mention the civic duty of contributing to increased herd immunity.

So, putting that all together, next thing was to research the vaccines available – Pfizer and Astra-Zeneca and decide which is preferable. This is a personal preference, however, I did troll through published research in journals like the Lancet and JAMA rather than the internet. In short, and based upon some of what is summarised above, I opted for Pfizer. 

Then, being over 60, I needed to find someone willing to give it to me. This was helped by having a dodgy medical history, and a local GP clinic obliged.

SO WHAT MIGHT HELP AVOID VACCINE SIDE-EFFECTS? What did I do?

In essence, it was all about using the 3 Principles of Positive Thinking and the art and science of Mind-Body Medicine

1. First Principle – Have a clear goal

Having done the research and contemplated the facts, I became clear… now was the time to be vaccinated and Pfizer was my vaccine of choice. 

But more than this, my strong intention was to gain excellent immunity – have the vaccine do its job well – and avoid side effects (I had researched and found good immunity is possible without side-effects).


2. Second principle – Do whatever it takes

i) Get organised – I found a local clinic that could administer Pfizer (well actually Ruth did that for me!)

ii) I made sure the day of the vaccination and the day after could be light on for activity.

iii) In preparation, during meditation and in my mind, I welcomed the vaccine as something that would do me good, strengthen my immune system and protect me from COVID. This was like talking to my body, explaining what was about to happen and reinforcing the benefit. I told the body emphatically there was no need for side-effects; what it was about to receive was all for our good. I had a very strong intention…

3. Third Principle – enjoy doing it

i) While sitting in the waiting room – for 1.25 hours!! – I had plenty of time to reinforce the welcome, relax and be primed for the injection.

ii) The injection was painless, I smiled, thanked the nurse and went home to lie down, relax and meditate. This involved a combination of deep relaxation, the letting go of meditation, and the active process of affirming the benefits and lack of side-effects with some imagery to that effect. 

iii) The last step was repeated over several days.

AND THE RESULT?

To be complete, on first returning home, I did have a strong sensation around my kidneys. I told myself this was just a sensation probably not related to the vaccination, and it passed within a couple of minutes. Apart from that I had no side-effects whatsoever. No injection site pain, no headache, no fatigue, no muscle pain, no sweats, nausea or mouth issues. Nothing.

SO WAS I JUST LUCKY?


Could be, but then it is nice to attempt something and have it work. Every time something like this happens it builds confidence in the Mind-Body connection, and who knows when we might really need that? 

Anyway, if there is something here you find helpful, good luck. 

May you and all you care for stay healthy and well.


RESOURCES

1. To read more about Mind-Body Medicine and how to apply it, You Can Conquer Cancer

2. For more on healing, try the downloads from our webstore

3. If you are not already connected, check out the meditation app I have helped develop : Allevi8

4. Finally, there are these 2 blogs that elaborate 5 principles you can learn and apply to accelerate the healing of any condition.

Accelerated healing – Part 1

Accelerated healing - Part 2



16 August 2021

Transforming lockdown in just 4 do-able steps

From what I am hearing, this latest round of lockdowns in Australia seems to be hitting many people far harder than the earlier ones. Previously, it was tough, very tough for some, but the lockdowns had the sense of being manageable. Seems like we may have reached a collective tipping point. 

So what to do? This week 4 simple, practical tips – all very do-able, especially for you meditators whether lapsed or current practitioners, or maybe 5, but first 


                 Thought for the day

                      Train your mind

                      As you would your dog

                     And the results

                     Will be wonderful

                                Rabbi Laibl Wolf


Transforming lockdown 

1. Practice meditation with a deep relaxation edge – just 10 – 20 minutes a day

We are in lockdown. Who has not got 10 – 20 minutes a day to regain this sense of profound physical and inner balance? That is all it takes to let go of tension, regain clarity and poise. At the same time, with the deep relaxation, we avert any risk of gathering a stress-related illness through the lockdown.

Recommendation

Just 10 – 20 minutes a day.

If you have not already, download the free Allevi8 app and listen to the Daily Practice daily!

Join the community of meditators who gather for the free Monday night group meditation sessions on Zoom – led by the great group of meditation teachers that also provide the individual meditation mentoring service for those who would like personalised teaching and support to practice.


2. Exercise most days – ideally daily

Again, this is ideal for your body and to get out in fresher air for a while.

Recommendation

Exercise at your own level. 

If you are fit, then go for it. 

If you need to be more reserved, the ideal level of exercise is one where you can keep up a conversation while doing it, and where you feel better at the end when compared to when you started.


3. Make a determined effort to generous of spirit – all the time

Recognise not everyone is coping so well. Some are really struggling with livelihoods at risk, families under great pressure. 

Recommendation

As much as possible, cut some slack; but more, do your best to be understanding, tolerant – and nice!




4. Practice gratitude – to you self and others – all the time

There are quite a few grumpy people around at present. Lots of glass half full stuff going on. Lots of fear, apprehension, anxiety; lots of genuine concern.

Recommendation

Again, as much as possible, recognise this is a time to look for the things we can be grateful for. This is very easy once you make the determination to do it. 

Everyone you meet or interact with has something they do that can be acknowledged, highlighted and serve as a source of gratitude. 

Same with our selves. Be generous of spirit, give emphasis to what you are doing well, go gentle on the touchy bits and acknowledge all the things that do warrant your own gratitude. 

Develop an attitude of gratitude…


FINALLY 

I hope not many others of you are Melbourne AFL supporters like me! After years of being very ordinary, here we are with our team top of the table in the middle of a pandemic lockdown. May not get to see any live finals. May not get to see a live grand final.

So if you think things are bad…

NOW, before some get too verbal, cut some slack… Maybe what really helps with transformation is

NUMBER 5

Develop, or maintain a sense of humour!!!


02 August 2021

PTSD, Mindfulness and meditation - what the research says

Did you know a cancer diagnosis is a very common cause of Posttraumatic Stress Disorder (PTSD)? Most will be aware PTSD is associated with major conflict like war or extreme personal trauma, yet it can also follow on from significant psychological distress. This is something I witnessed very commonly during decades of work helping people affected by cancer. In my opinion, and the research supports this view, well over 50% of people joining our groups came suffering from PTSD – and it also affected many of their partners and carers. Yet both our residential and non-residential programs seemed to clear it altogether.

So this week, what exactly is PTSD, and what have mindfulness and meditation to offer, but first

      Thought for the day

In the woods, we return to reason and faith. 

There I feel that nothing can befall me in life,

—no disgrace, no calamity, (leaving me my eyes,) 

Which nature cannot repair. 

Standing on the bare ground,

—my head bathed by the blithe air, 

And uplifted into infinite space,

—all mean egotism vanishes. 

I become a transparent eye-ball; 

I am nothing; I see all; 

The currents of the Universal Being circulate through me; 

I am part or particle of God.

                      Ralph Waldo Emerson


1. SPEAKING PERSONALLY

My own introduction to meditation and PTSD was through Dr Ainslie Meares. Dr Meares was a psychiatrist who helped survivors of World War 2 with what in those days was called “shell shock”. He found hypnotherapy useful, became a world authority and then moved on to become a leading pioneer in the use of therapeutic meditation; helping many people to use intense meditation as an adjunct to healing a wide range of conditions.

Having drawn heavily upon Dr Meares’ meditation techniques during my own recovery from a very difficult cancer, in 1981 I went on to develop what was probably the world’s first lifestyle-based cancer self help group. Meditation was at the heart of what we offered.

Now, most people when they first came to those groups seemed to be in severe distress. In the early eighties we had no name for it, but as the years went on, it was clear that well over half those in our groups were in fact suffering from PTSD. What was wonderful was that after attending either a 10 day residential program or 12 week non-residential program, nearly everyone was free of their PTSD symptoms. 

It remains one of the major regrets of my working life we were never able gather the funding or support to conduct a proper research trial on those groups’ effectiveness with PTSD. My sense is there was more to these consistent recoveries than "just" the mind techniques we taught, but they were very much at the heart of it. 

Anyway, here we are in current times when PTSD is a well-recognised and common issue besetting many people. Any event that involves a threat to life or a serious injury has the potential to be traumatic. This includes natural disaster, war, a serious accident, physical or sexual assault. And yes, strong psychological trauma like the diagnosis of cancer can also lead to PTSD.


2. THE SCOPE OF THIS LITERATURE REVIEW

This literature review aims to present key evidence regarding what mindfulness and meditation can offer to those affected by PTSD. Then, given the times we are in, it also examines the evidence base for online mindfulness and meditation programs. 

Quite a large body of research has been published in this field, but not surprisingly, it varies in quality. Therefore, while not exhaustive, this review aims to reproduce key research (using many direct quotes from that research) that investigates the efficacy of mindfulness and meditation for people affected by PTSD. 

This review includes direct hyper-links to the original scholarly articles as published. 


3. INTRODUCTION  

Stress affects us all differently; some people experience stress as a positive challenge, for others it leads to unwelcome distress. For a large number of people affected by significant trauma, that distress extends into the chronic and debilitating condition now known as Posttraumatic Stress Disorder (PTSD). 

Posttraumatic stress disorder (PTSD) affects the lives of 7-8% of adults in the U.S. 

In Australia, in any given year it is estimated around 4.4% of the population will be suffering from PTSD and around 5 - 10% of the population will suffer from PTSD sometime during their life. 

PTSD is a commons and devastating disorder. 

Although several interventions demonstrate clinical effectiveness for treating PTSD, many patients continue to have residual symptoms and ask for a variety of treatment options.

Both pharmacological and psychological interventions are used in the treatment of PTSD.

Despite empirical support of effectiveness, these interventions have high rates of incompletion (up to 50%) and many patients, both veterans and civilians, continue to have residual symptoms and seek more options.

For this prevalent and devastating disorder, the poor completion rates and relatively poor remission rates of existing, standard PTSD interventions suggest that new, complementary and integrative interventions, whether adjunctive or stand-alone, are likely warranted. Further, both patients and providers have voiced desires for the availability of more PTSD treatment options.

Meditation-based approaches are among the most popular complementary approaches for health promotion used by adults in both the U.S.A. and Australia. Meditation practices have elements of exposure, cognitive change, attentional control, self-management, relaxation, and acceptance, all of which are pertinent to the symptoms of PTSD.


3. WHAT IS PTSD? – with gratitude to Phoenix Australia 

Posttraumatic Stress Disorder (PTSD) is a set of reactions that can develop after someone has been through a traumatic event. 

Most people will experience at least one of these types of events during their lives. In the first days and weeks after a traumatic event, people often experience strong feelings of fear, sadness, guilt, anger, or grief. Generally, these feelings will resolve on their own, and with the support of family and friends, the person recovers. However, if the distress continues, it may mean that the person has developed PTSD or another mental health condition. 

A person with PTSD has four main types of difficulty: 

Re-living the traumatic event – through unwanted memories, vivid nightmares, flashbacks, or intense reactions such as heart palpitations or panic when reminded of the event. 

Feeling wound up – having trouble sleeping or concentrating, feeling angry or irritable, taking risks, becoming easily startled, or constantly being on the look-out for danger. 

Avoiding reminders of the event – activities, places, people, thoughts or feelings that bring back memories of the trauma. 

Negative thoughts and feelings – feeling afraid, angry, guilty, flat, or numb a lot of the time, losing interest in day-to-day activities, feeling cut off from friends and family. 

It is not unusual for people with PTSD to experience other mental health problems like depression or anxiety. Some people may develop a habit of using alcohol or drugs as a way of coping.


4. STANDARD TREATMENT

Almost everyone who goes through a traumatic event will be emotionally affected in some way. For some, the effects can be long lasting. If you are still experiencing problems two weeks after a traumatic event, it is worth talking to your GP or a mental health professional to assess how you are going and to see if treatment would be helpful. 

Effective treatments for posttraumatic stress disorder (PTSD) are available, and include counselling, medication, or a combination of both. These treatments can work even if your traumatic experience was a long time ago.


5. WHAT MINDFULNESS AND MEDITATION OFFER TO PEOPLE AFFECTED BY PTSD 

– A research-based overview

A recent major review observed mindfulness-based treatments of PTSD have emerged as promising adjunctive or alternative intervention approaches. 

The authors reviewed the literature on PTSD treatment studies, including approaches such as mindfulness-based stress reduction, mindfulness-based cognitive therapy and metta mindfulness, and found low attrition with medium to large effect sizes. 

This review examined the convergence between neurobiological models of PTSD and neuroimaging findings in the mindfulness literature, where mindfulness interventions may target emotional under- and overmodulation, both of which are critical features of PTSD symptomatology. Recent emerging work indicates that mindfulness-based treatments may also be effective in restoring connectivity between large-scale brain networks among individuals with PTSD, including connectivity between the default mode network and the central executive and salience networks. 

Future directions, including further identification of the neurobiological mechanisms of mindfulness interventions in patients with PTSD and direct comparison of these interventions to first-line treatments for PTSD are discussed.

Boyd JE et al. Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence. J Psychiatry Neurosci. 2018;43(1):7-25. doi:10.1503/jpn.170021

6. PTSD IN SPECIFIC SETTINGS

Posttraumatic Stress Disorder (PTSD) can be defined by the inability to recover from a traumatic event. A common misconception is that PTSD can only develop in circumstances of war or acute physical trauma. However, the diagnostic criteria of PTSD were adjusted in the Diagnostic Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) to include the diagnosis and treatment of a life-threatening illness, such as cancer, as a traumatic stressor that can result in PTSD. Here we examine PTSD in specific contexts.

i) PTSD and cancer

It is not unusual or surprising that many people experience a diagnosis of cancer as sudden, catastrophic, and/or life-threatening. Cancer-related PTSD (CR-PTSD) is often claimed to affect around 50% of those diagnosed with cancer. CR-PTSD can negatively affect a person’s psychosocial and physical well-being during treatment and into survivorship. Unfortunately, CR-PTSD often goes undiagnosed and, consequentially, untreated. 

This study reflects the commonly held view; it found the prevalence of distress amongst people with cancer was 76% and the incidence of PTSD was 55%.

Pranjic N et al. Distress and PTSD in patients with cancer: cohort study case. Mater Sociomed. 2016 Feb;28(1):12-6. doi: 10.5455/msm.2016.28.12-16. 


This next 2019 article provides a general overview of PTSD with cancer as the traumatic event in order to define CR-PTSD, and reviews the growing pool of literature on this topic, including prevalence, risk factors, characterization, and treatment of CR-PTSD. The purpose of this article is to spread awareness of this relatively newly defined and commonly missed disorder among patients with cancer to clinicians and patients alike.

Leano A et al. Are we missing PTSD in our patients with cancer? Part I. Can Oncol Nurs J. 2019;29(2):141-146. Published 2019 Apr 1.

ii) Mindfulness, PTSD and the military - systematic review and meta-analysis of the benefits 

Military veterans report high rates of psychiatric and physical health symptoms that may be amenable to mindfulness-based interventions (MBIs). However, inconsistent prior findings and questions of fit between MBIs and military culture highlight the need for a systematic evaluation of this literature.

The authors searched five databases and found 20 randomized controlled trials (RCTs) testing MBIs in military veterans to include in their analysis. The findings? MBIs were superior to non-specific controls (e.g., waitlist, attentional placebos) on measures of posttraumatic stress disorder (PTSD), depression, general psychological symptoms (i.e., aggregated across symptom domains), quality of life / functioning, and mindfulness but not physical health. At follow-up (mean length = 3.19 months), MBIs continued to outperform non-specific controls on general psychological symptoms, but not PTSD.

The author’s concluded MBIs may improve psychological symptoms and quality of life / functioning in veterans. Questionable acceptability and few high-quality studies support the need for rigorous RCTs, potentially adapted to veterans.

Goldberg SB et al. Efficacy and acceptability of mindfulness-based interventions for military veterans: A systematic review and meta-analysis. J Psychosom Res. 2020 Nov;138:110232. 

iii) Mindfulness use for PTSD in children

We all know many children are exposed to adverse experiences. The evidence is clear - such adverse childhood exposures may result in stress and trauma, which are associated with increased morbidity and mortality into adulthood. 

In general populations and trauma-exposed adults, mindfulness interventions have demonstrated reduced depression and anxiety, reduced trauma-related symptoms, enhanced coping and mood, and improved quality of life. Studies in children and youth also demonstrate that mindfulness interventions improve mental, behavioural, and physical outcomes. 

Taken together, this research suggests that high-quality, structured mindfulness instruction may mitigate the negative effects of stress and trauma related to adverse childhood exposures, improving short- and long-term outcomes, and potentially reducing poor health outcomes in adulthood. Future work is needed to optimize implementation of youth-based mindfulness programs and to study long-term outcomes into adulthood.

Ortiz R, Sibinga EM. The Role of Mindfulness in Reducing the Adverse Effects of Childhood Stress and Trauma. Children (Basel). 2017;4(3):16. Published 2017 Feb 28. doi:10.3390/children4030016


7. META-ANALYSES AND MAJOR REVIEWS – Mindfulness, meditation and PTSD

i) 2016 review finds positive but statistically weak benefits

This systematic review and meta-analysis synthesized evidence from randomized controlled trials of meditation interventions to provide estimates of their efficacy and safety in treating adults diagnosed with posttraumatic stress disorder (PTSD). Outcomes of interest included PTSD symptoms, depression, anxiety, health-related quality of life, functional status, and adverse events.

In total, 10 trials on meditation interventions for PTSD with 643 participants met inclusion criteria. Across interventions, adjunctive meditation interventions of mindfulness-based stress reduction, yoga, and the mantra repetition program improve PTSD and depression symptoms compared with control groups, but the findings are based on low and moderate quality of evidence. Effects were positive but not statistically significant for quality of life and anxiety, and no studies addressed functional status. 

The authors concluded meditation appears to be effective for PTSD and depression symptoms, but in order to increase confidence in findings, more high-quality studies are needed on meditation as adjunctive treatment with PTSD-diagnosed participant samples large enough to detect statistical differences in outcomes.

Hilton L et al. Meditation for posttraumatic stress: Systematic review and meta-analysis. Psychol Trauma. 2017 Jul;9(4):453-460. 

ii) 2017 Meta-analysis finds meditation offers significant help

In this 2017 meta-analysis, 19 randomized control trials with data on 1,173 participants were reviewed. A random effects model yielded statistically significant positive effects in the small to medium range. Interestingly, the study revealed no appreciable differences between intervention types, study population, outcome measures, or control condition. 

The authors concluded these findings suggest meditation (and yoga) are promising complementary approaches in the treatment of PTSD among adults and warrant further study.

Gallegos AM et al. Meditation and yoga for posttraumatic stress disorder: A meta-analytic review of randomized controlled trials. Clin Psychol Rev. 2017;58:115-124. 


8. SOME CAUTIONS RE MINDFULNESS and PTSD

While mindfulness has much to offer, there are some cautions and this article from Smiling Minds is worth reading if you are taking up that specific practice…

Mindfulness and traumatic stress - best practice guidelines. Catherin Morey-Nase, March 2021, Smiling Mind Blog.

Author's note : In my own experience, starting any mindfulness or meditation-based practice with deep relaxation as in the Progressive Muscle Relaxation, significantly mitigates any potential adverse effects. As such, I highly recommend this practice.


9. ONLINE MINDFULNESS AND MEDITATION PROGRAMS FOR PEOPLE WITH PTSD

i) Online programs and their benefits – a meta-analysis

The aim of this meta-analysis of 15 randomised controlled studies was to estimate the overall effects of online MBIs on mental health. Results showed that online MBIs have a small but significant beneficial impact on depression, anxiety, well-being and mindfulness. The largest effect was found for stress, with a moderate effect size.

For stress and mindfulness, analysis demonstrated significantly higher effect sizes for guided online MBIs than for unguided online MBIs. In addition, effect sizes for stress were significantly moderated by the number of intervention sessions. 

The researchers concluded their findings indicate online MBIs have potential to contribute to improving mental health outcomes.

Spijkerman MPJ et al. Effectiveness of online mindfulness-based interventions in improving mental health: A review and meta-analysis of randomised controlled trials. Clinical Psychology Review Vol 45, 2016, 102-114  

ii) App use improves mental health

Previous research has shown one in five Australians (21%) have taken time off work in the past 12 months due to feeling stressed, anxious, depressed or mentally unhealthy. Workers who took part in this 30 day app trial were assessed over 12 months and reported fewer depressive symptoms while scores for workplace performance, resilience and wellbeing had improved.

“This is the first time researchers have ever been able to achieve reductions in depression incidence using an app alone,” claimed the lead author Dr Mark Deady.

Reference : Click here


PART D  :   CONCLUSION

There is a solid evidence base for mindfulness and meditation being used to help people affected by PTSD. These same interventions can play a part in reducing associated symptoms of PTSD such as anxiety and depression, as well as assist in recovery. 

Also, there is good evidence online mindfulness - based programs have positive benefits and that these benefits are increased with the support of an on-line guide or mentor. Further, the evidence concludes that increasing the number of guided sessions increases the measured benefits.