31 December 2022

A fresh look at making New Year’s resolutions work…

Another year is beginning… We could just go with the flow, take life as it is, and be ourselves. 
But then, feeling completely at ease with ourselves, and with the way our lives are unfolding, may be a step or two away. There may well be things we would like to be different… 
Time for another New Year’s resolution? If so, how to make it stick? 
This week, a new approach that really does work, but first 

       Thought for the day
Taking life seriously does not mean spending our whole life meditating 
As if we were living in the Himalaya Mountains or in the old days in Tibet. 
In the modern world, we have to work to earn our living,
But we should not get entangled in a nine-to-five existence, 
Where we live without any view of the deeper meaning of life.
Our task is to strike a balance, 
To find a middle way, 
To learn not to overextend ourselves 
With extraneous activities and preoccupations, 
But to simplify our lives more and more. 
The key to finding a happy balance in modern life is simplicity.
                     Sogyal Rinpoche
The wonderful thing about New Year’s resolutions is they always seem so sound, so logical. 
This year I will meditate more. This year I will drink less, exercise more, be kinder, more tolerant, more aware, more forgiving… all so sound, so logical; how could we not take up on any of that? Yet for many, a week or two into January, not only has the change not been accomplished, it is probably even forgotten!
So… how to actually make personal change? How to work with our mind? 
Having helped people with this for decades, many readers will probably be familiar with the Three Principles of Positive Thinking. These Principles have helped many people to set goals, follow through and accomplish them. Changing habits, changing environments, changing ways of relating – these 3 steps really do work. But in this post, a new take; another way of making personal change. 
(You can check out the Three Principles in The Mind that Changes Everything or You Can Conquer Cancer).
The fresh approach? 
Answer these 5 questions: What?, Why?, How?, When?, and How much?
1. What - Set Your Goal. Three important points:
i) Goals can come to us courtesy of whims, emotions, rational thought, contrariness, contemplation – or because somebody tells us what to do! 
Best be clear where your goals are coming from, and make a deliberate choice. 
Experience is pretty clear here; the best goals come from combining the use of the intellect and contemplation. Details are in The Mind that Changes Everything.
ii) A goal can be focussed upon an outcome or an action. Both are valid, but quite different. 
An outcome might be catching a plane overseas and as such is quite time dependant and uncompromising. The actions required to purchase the ticket and get on the plane may change over time and benefit from a flexible approach, but the time of departure is fixed. 
Many goals are like that; the outcome is fixed, the actions required to accomplish the outcome may well need to change to adapt to evolving circumstances and as such, are best to be flexible. Here, the goal is uncompromising, the actions are flexible. 
An action might be to meditate daily – no wriggle room there – you either do it or you do not. You may relapse and need to recommit, but basically, the aim is to be doing the action as intended. Here, the goal is the action and as such it is inflexible.
iii) Aim to reduce your goal to a few words, and express it as an affirmation – in the first person, present tense, as if it has already happened. And in a way that is joyful!
Example? Not I hope to meditate daily and with a bit of luck maybe I will some time off in the future, but it seems a bit unlikely, I have tried it before and it was pretty difficult… ; rather I really enjoy meditating daily, now. The mind responds to hearing this - first person, present tense, as if it has already happened, not the previous vague waffle.

2. Why?
Why is it time for this change? 
Example? Maybe you have been meditating off and on… Very common… But maybe it is becoming even clearer: when I do meditate everything seems easier, everything seems to work out better. Funny that… 
Maybe you do need to heal something? Maybe you do aspire to becoming a better person? Maybe it is time to get to know yourself a little more deeply?
The stronger the Why, the easier the How.

3. How?
What will it take to accomplish this goal? 
What do I need to do? 
Example? Meditating daily. 
If you have good personal discipline, you probably do not need to read on; just do it. 
However, many I have helped over the years did have good, clear goals, and yet they struggled to accomplish them. 
If this is you, you need to plan.
Consider supports like establishing a routine, setting up a good practice space, starting small and building, providing yourself with rewards once landmarks are passed, seeking contact with teachers and like-minded company you can learn from, share your goals and your progress with, consider writing a journal, record your practice and share your results with those close to you. What does it take?

4. When?
Some goals have a definite timing to them, like catching a plane; others are more flexible.
Unless the goal is time dependant – like the plane trip – it is preferable to keep the time for accomplishment open. This is not a cop out; some goals might take longer than planned, others be accomplished quicker. It works to keep the time open where possible.

5. How much?
This may well be the most important step to get clear. Is this goal, this new resolution, a matter of life and death? Will you do absolutely everything possible to accomplish this goal? Or is it a matter a little importance? If it works out, all to the good; but if not, who cares???
This question when answered brings the previous 4 together into an intention – that motivating force that can be casual or unstoppable depending upon how much you want it. 
I remember in my sporting days, training each day was a non-negotiable; it was what I did every day and all else needed to fit in around that. When I was really ill back in the 70’s, healing was my priority and all else needed to fit in around that.
When the goal is clear and the intention is strong, amazing things happen. “Miracles” happen. 

May 2023 be a year of personal miracles for you and all you care for and about…
Allevi8 App – free meditation practice app with options for online group teaching/mentoring
Digital downloads – Mind training

20 December 2022

Mindfulness as effective as an antidepressant for anxiety

If you have some anxiety, you are not alone. Whilst in 2022, 63.4% of adults were estimated to have no anxiety, 25.5% had low level anxiety, 7.1% medium anxiety, and 4.1% were claimed to have high anxiety.

So what to do? What does the evidence say? New research published just last month has shown a guided mindfulness-based stress reduction program was as effective for patients with anxiety disorders as the gold-standard drug - the common antidepressant escitalopram. So this week, how to apply this knowledge and details of the study itself, but first

         Thought for the day

   One forgets the self, 

   Zen teachers say, 

   By becoming one with the task at hand. 

   At such moments, 

   Released from the burdens of selfhood, 

   One glimpses, however briefly, 

   A state of spiritual wholeness that underlies 

   And supports one’s everyday consciousness.

                         Andrew Cooper

Common side effects of escitalopram are listed to include trouble sleeping, nausea, sexual dysfunction, drowsiness and feeling tired. More serious side effects may include suicidal thoughts in people up to the age of 24 years.  It is unclear if use during pregnancy or breastfeeding is safe.

Research establishes common effects of mindfulness include better sleep, good digestion (and with use of our Allwevi8 app, a specific and significant drop in nausea for those affected by it), sexual satisfaction and increased energy levels. When used during pregnancy, there is likely to be increased calm and ease in both mother and baby, and breastfeeding is likely to be facilitated for the better due to this increased calm and ease.

Of note, approximately 15% of the U.S. population tried some form of meditation in 2017.

This said, anxiety disorders can be very tough. Anxiety disorders include generalized anxiety, social anxiety, panic disorder and fear of certain places or situations, including crowds and public transportation, all of which can lead to an increased risk for suicide, disability and distress. Therefore, these disorders when severe are commonly treated in psychiatric clinics. 

In October this year, the United States Preventive Services Task Force for the first time, recommended screening for anxiety disorders due to the high prevalence of these disorders.

Drugs that are currently prescribed for the disorders can be very effective, but many patients either have difficulty getting them, do not respond to them, or find the side effects as a barrier to consistent treatment.

Elizabeth Hoge, MD, director of the Anxiety Disorders Research Program, associate professor of psychiatry at Georgetown and lead author commented:

"Our study provides evidence for clinicians, insurers, and healthcare systems to recommend, include and provide reimbursement for mindfulness-based stress reduction as an effective treatment for anxiety disorders because mindfulness meditation currently is reimbursed by very few providers." 

"A big advantage of mindfulness meditation is that it doesn't require a clinical degree to train someone to
become a mindfulness facilitator. 

Additionally, sessions can be done outside of a medical setting, such as at a school or community center."

Standardized mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR), can decrease anxiety, but prior to this study, the interventions had not been studied in comparison to effective anti-anxiety drugs. 

The clinicians recruited 276 patients between June 2018 and February 2020 from three hospitals in Boston, New York City and Washington, D.C., and randomly assigned people to either MBSR or escitalopram. MBSR was offered weekly for eight weeks via two and a half-hour in-person classes, a day-long retreat weekend class during the 5th or 6th week, and 45-minute daily home practice exercises. 

Patients' anxiety symptoms were assessed upon enrolment and again at completion of the intervention at 8 weeks, along with post-treatment assessments at 12 and 24 weeks after enrolment. The assessments were conducted in a blinded manner -- the trained clinical evaluators did not know whether the patients they were assessing received the drug or MBSR.

At the end of the trial, 102 patients had completed MBSR and 106 had completed their medication course. The patients were relatively young, with a mean age of 33 and included 156 women, which comprised 75% of the enrolees, mirroring the disease prevalence in the U.S.

The researchers used a validated assessment measure to rate the severity of symptoms of anxiety across all of the disorders using a scale of 1 to 7 (with 7 being severe anxiety). Both groups saw a reduction in their anxiety symptoms (a 1.35 point mean reduction for MBSR and 1.43 point mean reduction for the drug, which was a statistically equivalent outcome), dropping from a mean of about 4.5 for both, which translates to a significant 30% or so drop in the severity of peoples' anxiety.

"It is important to note that although mindfulness meditation works, not everyone is willing to invest the time and effort to successfully complete all of the necessary sessions and do regular home practice which enhances the effect," Hoge said. 

"Also, virtual delivery via videoconference is likely to be effective, so long as the 'live' components are retained, such as question-and-answer periods and group discussion."

Trial enrolment was wrapping up as the COVID pandemic started in early 2020 but most enrolees completed their eight-week course of treatment before the pandemic started. 

The researchers conducted a second phase of the study during the pandemic that involved moving the treatments to an online, videoconference, and that will be the focus of future analyses. The researchers also hope to explore the effects of MBSR on sleep and depression.

Reference: Hoge AE et al. Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults with Anxiety Disorders. JAMA Psychiatry, 2022; DOI: 10.1001/jamapsychiatry.2022.3679

NOTE The Allevi8 app with its attendant online personalised, live mentor/teaching sessions, includes mindfulness techniques as well as meditation, contemplation, guided imagery and deep relaxation.