‘Mindfulness therapy may be helpful for managing effects of Post Traumatic Stress Disorder (PTSD) among veterans. ’
#PTSD #Meditation #Mindfulness
Shifting brain connections
The changes showed up on functional MRI, or fMRI, brain scans that can visualize brain activity as different areas of the brain “talk” to one another through networks of connections between brain cells.
Before the mindfulness training, when the veterans were resting quietly, their brains had extra activity in regions involved in responding to threats or other outside problems. This is a sign of that endless loop of hypervigilance often seen in PTSD.
“The brain findings suggest that mindfulness training may have helped the veterans develop more capacity to shift their attention and get themselves out of being “stuck” in painful cycles of thoughts,” says Anthony King, a U-M Department of Psychiatry researcher who led the new study in collaboration with VA psychologists.
“We’re hopeful that this brain signature shows the potential of mindfulness to be helpful for managing PTSD for people who might initially decline therapy involving trauma processing,” he adds. “We hope it may provide emotional regulation skills to help bring them to a place where they feel better able to process their traumas.”
A palatable option
Before they launched the study, the researchers weren’t sure that they could find enough veterans to try mindfulness-based training. After all, it has a reputation as an “alternative” approach and has a relationship to traditionally East and South Asian practices like meditation and yoga.
But in fact, more of the initial group of veterans stuck with mindfulness-based therapy sessions – held each week for two hours with a trained mindfulness teacher and psychotherapist – than made it all the way through the comparison psychotherapy group that didn’t get mindfulness training.
The comparison group received a VA-developed intervention that was designed for “control group” use. It included problem-solving and group support but not mindfulness or exposure therapy.
The mindfulness group saw improvement in PTSD symptoms, in the form of decreased scores on a standard scale of PTSD severity, which was statistically significant and considered clinically meaningful, whereas the control group did not.
“Mindfulness can help people cope with and manage their trauma memories, explore their patterns of avoidance when confronting reminders of their trauma, and better understand their reactions to their symptoms,” says King. “It helps them feel more grounded, and to notice that even very painful memories have a beginning, a middle and an end — that they can become manageable and feel safer. It’s hard work, but it can pay off.”
At the start of the study, and in previous U-M/VA work, the fMRI scans of veterans with PTSD showed unusual activity. Even when they were asked to rest quietly and let their minds wander freely, they had high levels of activity in brain networks that govern reactions to salient, or meaningful, external signals such as threats or dangers.
But at the end of the mindfulness course, the default mode area was more active – and showed increased connections to areas of the brain known as the executive network.
“We were surprised by the findings, because there is thinking that segregation between the default mode network and the salience network is good,” says King. “But now we are hopeful that this brain signature of increased connection to areas associated with volitional attention shifting at rest may be helpful for managing PTSD, and may help patients have more capacity to help themselves get out of being stuck in painful ruts of trauma memories and rumination.”
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