Compassion and palliative care

Compassionate, loving kindness and mindfulness interventions in a palliative care setting.

pexels-photo-748780.jpeg

Authors: Claudia Orellana-Rios, Lukas Radbruch, Martina Kern, Yesche Regel, Andreas Anton, Shane Sinclair and Stefan Schmidt

Year: 2017

Title: Mindfulness and compassion-oriented practices at work reduce distress and enhance self-care of palliative care teams: a mixed-method evaluation of an “on the job“ program

Summary: Notwithstanding the extensive body of work exploring meditation and mindfulness, there is a shortage of studies that address the potential of compassion based interventions in the workplace. A national survey of palliative care practitioners had established that for 42% of respondents, frequent patient deaths was a challenging aspect of their work. Although many people report beneficial effects from delivering compassionate care, extensive exposure to suffering can be a problem for workers. This investigation recruited participants from a palliative care centre in Bonn, Germany.  Ten weeks of training in meditation combining a number of elements including, mindfulness, loving kindness and tong-len was provided. A range of mixed measures was used to establish the benefits of the practice including, a battery of self-reporting questionnaires, semi-structured interviews and a physiological measure. In conclusion, no evidence that participants experienced an increase in compassion was observed. However, improvements were reported by participants in areas including self-care and emotional regulation. The was no significant change to the cortisol levels taken as part of the trial.

Given the complex nature of introducing compassion into this particular work environment, the mixed method approach should be commended. Where compassion, loving-kindness and mindfulness are brought together as an ‘omnibus’ approach, a degree of epistemological plurality is likely to be required to gain a full understanding of the results. Reliably evaluating the effects of one approach (such as compassion) in such a trial can be a challenge in itself. However to integrate three approaches (mindfulness, compassion and loving-kindness) into a working environment, then to understand their effect individually and collectively, is making great demands of the self-reporting instruments.

It should be noted that in a recent meta-study investigating the pro-social effects of meditation, the teaching of the meditation practice by a co-author of the research was seen to be an influential factor. The precise nature of the meditation taught in this case is unclear and may, to some extent, be related to the individual approach of the teacher. The assumption that different kinds of meditation, such as compassion (tong-len), all fit within an easily replicated framework is perhaps the result of the theoretical uncertainty withing psychology towards contemplative science. There is still a shortage of data exploring how interrelated constructs such as loving-kindness and compassion might influence behaviour in the workplace. In this regard, the study provides useful information that may help the understanding of these constructs in particular working environments.

Link: https://bmcpalliatcare.biomedcentral.com

Putting the Meditator at the Centre of the Research

Meditators know the most about meditation, if science ignores them they miss a trick.

pexels-photo.jpg

(The research is now complete, thanks to all who participated)

Do you meditate or practice mindfulness?

I am currently undertaking an academic survey into meditation and wellbeing. I would like to ask meditators over the age of 18 to complete a short anonymous questionnaire about their practice (it should take around ten minutes). The research has been ethically approved and conforms to all the usual academic norms.

This important research seeks to capture the meditation and mindfulness experience of practitioners of different levels of experience and backgrounds. Based on meditators self reported insights, this projects follows recent signposts in contemplative science putting greater emphasis on the experiential nature of mindfulness and meditation.

Regards

SGM

Loving-kindness Meditation for Posttraumatic Stress Disorder: A Pilot Study

What is the effect of loving kindness meditation for post traumatic stress disorder

pexels-photo-48566.jpeg

Authors: Kearney DJ, Malte CA, McManus C, Martinez ME, Felleman B, Simpson TL.

Year: 2013

Title: Loving-kindness Meditation for Posttraumatic Stress Disorder: A Pilot Study

Summary: A trial of loving kindness meditation was undertaken with veterans suffering from posttraumatic stress disorder (PTSD). Participants were given 12 weeks training in loving-kindness meditation and measured for PTSD, depression, self-compassion, and mindfulness at different stages. The effects of this pilot demonstrated a range of benefits for participants from the meditation and concluded that the practice was both “safe” and “acceptable”. A pilot study but really strong participant attendance (74% involved in 9 to 12 classes) and fascinating results:

  • self-compassion increased with large effect
  • mindfulness increased with medium to large effect
  • PSTD symptoms subject to a large effect at 3-month follow-up (d = -0.89)
  • depression  subject to a medium effect at 3 months

Perspective: Health psychology, positive psychology, clinical psychology

Link: http://www.ncbi.nlm.nih.gov/pubmed/23893519

Regulation of the Neural Circuitry of Emotion by Compassion Meditation: Effects of Meditative Expertise

Authors: Antoine Lutz, Julie Brefczynski-Lewis, Tom Johnstone, Richard J. Davidson

Year: 2008

Title: Regulation of the Neural Circuitry of Emotion by Compassion Meditation: Effects of Meditative Expertise

Summary: Functional magnetic resonance imaging (fMRI) investigation of the insula and anterior cingulate cortices in empathic response during loving-kindness, compassionate meditation. The contrast between rest and meditation states indicated increased activation in amygdala, right temporo-parietal junction (TPJ), and right posterior superior temporal sulcus (pSTS). The findings when taken in their entirety suggests the cultivation of positive emotional states through meditation creates changes to the activation of circuitries  linked to empathy and theory of mind in response to emotional stimuli.

Perspective: Neuroscience

Link: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0001897

Open Hearts Build Lives: Positive Emotions, Induced Through Loving-Kindness Meditation, Build Consequential Personal Resources

Authors: Barbara L. Fredrickson,  Michael A. Cohn, Kimberly A. Coffe, Jolynn Pek and Sandra M. Finkel.

Year: 2008

Title: Open Hearts Build Lives: Positive Emotions, Induced Through Loving-Kindness Meditation, Build Consequential Personal Resources

Summary: Does meditation practice produce a cumulative effect? Is there a relationship between meditation and positive emotions, which, in turn produce increased personal resources connected to life satisfaction and reduced depressive symptoms.

Perspective: Social Psychology, Positive Psychology

Link: http://www.unc.edu/peplab/publications/Fredrickson%20et%20al%202008.pdf

Loving-Kindness Meditation for Chronic Low Back Pain

Authors: James W. Carson, Francis J. Keefe, Thomas R. Lynch, Kimberly M. Carson, eeraindar Goli, Anne Marie Fras and Steven R. Thorp

Year: 2005

Title: Loving-Kindness Meditation for Chronic Low Back Pain

Summary: A pilot study on the effects of an eight week loving-kindness meditation program for patients suffering with chronic low back pain. Participants measured for pain, anger, and psychological distress. Analyses of data suggested a relationship between loving-kindness meditation and  lower pain on the day of meditation and a lower experience of anger the following day.

Perspective: Social Cognitive, Health Psychology

Link: http://jhn.sagepub.com/content/23/3/287.abstract

Loving-kindness Meditation Increases Social Connectedness

Loving kindness meditation

Authors: Hutcherson CA, Seppala EM, Gross JJ.

Year: 2008

Title: Loving-kindness meditation increases social connectedness

Summary: This research examines the relationship between social connectedness and meditation. It discusses whether social connectedness could be created toward strangers in a controlled laboratory context. The findings imply that even brief exposure to loving kindness meditation (LKM) may offer some relief from the experience from social isolation.

Perspective: Social cognitive, neuroscience

Link: http://www.ncbi.nlm.nih.gov/pubmed/18837623