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  • Evidence based Yoga

    Yoga is a mind and body practice in complementary medicine with origins in ancient Indian philosophy. The various styles of yoga that people use for health purposes typically combine physical postures, breathing techniques, and meditation or relaxation. There are numerous schools of yoga. Hatha yoga, the most commonly practiced in the United States and Europe, emphasizes postures (asanas) and breathing exercises (pranayama).

    Since the 1020’s researchers have been studying and publishing articles on the results of a Yoga practice. Listed below are some of the research results of Hatha Yoga and specific medical conditions. :

    young woman excercising power yoga

    ADHD Eighteen boys with diagnosed attention-deficit/hyperactivity disorder (ADHD) were randomly assigned to either a yoga treatment or a cooperative activities group. After 20 sessions of yoga, the boys showed improvement on a variety of indices, including oppositional behavior, emotional lability, and restlessness or impulsivity. The subjects exhibited a dose/ response curve, with those subjects who participated in additional home practice showing a greater response. The control group showed superior scores on measures of hyperactivity, anxiety, and shyness, as well as social function measures.7

    Anxiety A meta-analysis of the research involving yoga interventions for anxiety and related disorders reviewed eight studies conducted during 2004. Overall, this research reported positive results, especially in cases of obsessive-compulsive disorder. However, the authors were quick to point out a generally poor quality of research techniques, inadequacies in methodology, and difficulty comparing studies.8 A Cochrane review of two RCTs that investigated the effectiveness of meditation and yoga on patients with diagnosed anxiety disorders stated that based on the available research, no distinct conclusions can be drawn on the ability of meditation and yoga to be effective for anxiety disorders.9

    Asthma To determine the efficacy of Iyengar yoga practice on symptoms and perceived quality of life of people living with asthma, 62 patients with mild to moderate asthma were randomized and divided into two groups. The treatment group performed Iyengar yoga for 4 weeks, and the control group enrolled in a “stretching” program. Both groups underwent spirometry testing and recorded their bronchodilator use, symptoms, and quality of life assessments. At no point in the study did the yoga intervention group show a measured benefit in clinical indices.10
    Another small RCT divided 17 subjects into a yoga treatment and a control group. The yoga group engaged in relaxation pranayama (mindful breathing) techniques, yoga postures, and meditation 3 times per week for 16 weeks. Spirometry testing showed little difference between the two groups; however, the yoga group showed improved exercise tolerance and reported relaxation as well as a more positive attitude as measured by questionnaire. This study also showed a trend toward less use of short-acting bronchodilator medication in the yoga group.11

    Back pain A 12-week RCT compared viniyoga practice with conventional therapeutic back exercises or a self-help book for 101 patients with chronic low back pain. The yoga group met with one instructor for a weekly 75-minute viniyoga practice. Patients were also encouraged to practice at home daily and were given handouts and an audio CD guide. This group showed greater improvement in functional status, decreased activity restriction, and increased general health compared to the conventional exercise group or the self-help book group at 12 weeks. At 26 weeks post treatment, the conventional exercise and yoga therapy group did not show a significant difference in outcome, though at all points in time, viniyoga therapy appeared to be more effective than the self- care book. The viniyoga benefit also lasted for months after the intervention.12

    Cardiovascular disease A systematic literature review of 70 studies published over the past two decades showed a trend toward beneficial changes in metabolic syndrome risk factors such as insulin resistance, lipid profiles, BP, and anthropomorphic indices. The author noted that by controlling risk factors for metabolic syndrome, a regular yoga practice might possibly reduce the risk of cardiovascular disease (CVD). It is important to note that approximately one-third of the reviewed studies were RCTs and that the majority of the others were uncontrolled or nonrandomized controlled clinical trials.4 A 2002 comprehensive review of the literature on the psychophysiological effects of hatha yoga concluded that regular hatha yoga practice and a “yoga lifestyle” have the potential to benefit CVD risk indices.5

    Cardiovascular fitness A 50-minute hatha yoga routine burns 2.2 to 3.6 kcal/min, the equivalent a very slow walk. Except in persons who are very deconditioned, this type of yoga practice alone is unlikely to have a significant training effect on cardiovascular fitness, pulmonary function, body composition, or fat metabolism.13 More vigorous forms of power or vinyasa yoga require a higher energy output, depending on the method of teaching and selection of asanas (postures). One recent study demonstrated a 7% increase in VO2 max after previously sedentary subjects practiced 8 weeks of yoga training.13 However, the general consensus is that yoga does not provide the significant cardiovascular stimulus necessary to enhance cardiovascular function.14

    REFERENCES

    1. Tindle HA, Davis RB, Phillips RS, Eisenberg DM. Trends in use of complementary and alternative medicine by US adults: 1997-2002. Altern Ther Health Med. 2005;11(1):42-49.
    2. Carrico M. Yoga Journal’s Yoga Basics: The Essential Beginner’s Guide to Yoga for a Lifetime of Health and Fitness. New York, NY: Henry Holt and Company; 1997.
    3. Nayak NN, Shankar K. Yoga: a therapeutic approach. Phys Med Rehabil Clin N Am. 2004;15(4): 783-798, vi.
    4. Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: a systematic review. J Am Board Fam Pract. 2005;18(6):491-519.
    5. Raub JA. Psychophysiologic effects of Hatha yoga on musculoskeletal and cardiopulmonary function: a literature review. J Altern Complement Med. 2002;8(6):797-812.
    6. Luskin FM, Newell KA, Griffith M, et al. A review of mind-body therapies in the treatment of musculoskeletal disorders with implications for the elderly. Altern Ther Health Med. 2000;6(2): 46-56.
    7. Jensen PS, Kenny DT. The effects of yoga on the attention and behavior of boys with attentiondeficit/ hyperactivity disorder (ADHD). J Atten Disord. 2004;7(4):205-216.
    8. Kirkwood G, Rampes H, Tuffrey V, et al. Yoga for anxiety: a systematic review of the research evidence. Br J Sports Med. 2005;39(12):884-891.
    9. Krisanaprakornkit T, Krisanaprakornkit W, Piyavhatkul N, Laopaiboon M. Meditation therapy for anxiety disorders. Cochrane Database Syst Rev. 2006;(1):CD004998.
    10. Sabina AB, Williams AL, Wall HK, et al. Yoga intervention for adults with mild-to-moderate asthma: a pilot study. Ann Allergy Asthma Immunol. 2005;94(5):543-548.
    11. Vendanthan PK, Kesavalu LN, Murthy KC, et al. Clinical study of yoga techniques in university students with asthma: a controlled study. Allergy Asthma Proc. 1998;19(1):3-9.
    12. Sherman KJ, Cherkin DC, Erro J, et al. Comparing yoga, exercise, and a self-care book for chronic low back pain: a randomized, controlled trial. Ann Intern Med. 2005;143(12):849-856.
    13. Tran MD, Holly RG, Lashbrook J, Amsterdam EA. Effects of Hatha yoga practice on the healthrelated aspects of physical fitness. Prev Cardiol. 2001;4(4):165-170.
    14. Clay CC, Lloyd LK, Walker JL, et al. The metabolic cost of Hatha yoga. J Strength Cond Res. 2005;19(3):604-610.

  • soft practice

    Be soft in your practice. Think of the method as a fine silvery stream, not a raging waterfall. Follow the stream, have faith in its course. It will go its own way, meandering here, trickling there. It will find the grooves, the cracks, the crevices. Just follow it. Never let out of your sight. It will take you. Sheng-yen

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  • Study brain can be trained in compassion

    Researchers at the Center for Investigating Healthy Minds at the Waisman Center of the University of Wisconsin-Madison examined whether training adults in compassion can result in greater altruistic behavior and related changes in neural systems underlying compassion.
    In the study, the investigators trained young adults to engage in compassion meditation, an ancient Buddhist technique to increase caring feelings for people who are suffering.
    In the meditation, participants envisioned a time when someone has suffered and then practiced wishing that his or her suffering was relieved.8d337-260291_10151674843907518_1073142538_n
    Participants practiced with different categories of people, first starting with a loved one, someone whom they easily felt compassion for, like a friend or family member. Then, they practiced compassion for themselves and a stranger.
    Finally, they practiced compassion for someone they actively had conflict with called the “difficult person”, such as a troublesome coworker or roommate.
    “It’s kind of like weight training. Using this systematic approach, we found that people can actually build up their compassion ‘muscle’ and respond to others’ suffering with care and a desire to help,” said Helen Weng, lead author of the study and a graduate student in clinical psychology.
    Compassion training was compared to a control group that learned cognitive reappraisal, a technique where people learn to reframe their thoughts to feel less negative.
    “We wanted to investigate whether people could begin to change their emotional habits in a relatively short period of time,” said Weng.
    The real test of whether compassion could be trained was to see if people would be willing to be more altruistic – even helping people they had never met.
    “We found that people trained in compassion were more likely to spend their own money altruistically to help someone who was treated unfairly than those who were trained in cognitive reappraisal,” Weng said.
    The study measured changes in brain responses using functional magnetic resonance imaging (fMRI) before and after training.
    The researchers found that the people who were the most altruistic after compassion 260291_10151674843907518_1073142538_ntraining were the ones who showed the most brain changes when viewing human suffering.
    They found that activity was increased in the inferior parietal cortex, a region involved in empathy and understanding others.
    Compassion training also increased activity in the dorsolateral prefrontal cortex and the extent to which it communicated with the nucleus accumbens, brain regions involved in emotion regulation and positive emotions.

  • Emotional Intelligence

    I often work with groups using lists. In movement therapy as well as psychotherapy, educational and process oriented groups lists are a great structure for groups to explore thoughts, and/or feelings. Here is a list that often comes up in groups ten suggestions about feelings.
    1. Become emotionally literate. Label your feelings, rather than labeling people or situations.
    Use three word sentences beginning with “I feel”.
    Start labeling feelings; stop labeling people & situations msclip-210
    “I feel impatient.” vs “This is ridiculous.” I feel hurt and bitter”. vs. “You are an insensitive jerk.”
    “I feel afraid.” vs. “You are driving like an idiot.”
    2. Distinguish between thoughts and feelings.
    Thoughts: I feel like…& I feel as if…. & I feel that
    Feelings: I feel: (feeling word)
    3. Take more responsibility for your feelings.
    “I feel jealous.” vs. “You are making me jealous.”
    Analyze your own feelings rather than the action or motives of other people. Let your feelings help you identify your unmet emotional needs.
    4. Use your feelings to help make decisions
    “How will I feel if I do this?” “How will I feel if I don’t?”
    “How do I feel?” “What would help me feel better?”
    Ask others “How do you feel?” and “What would help you feel better?”
    5. Use feelings to set and achieve goals
    – Set feeling goals. Think about how you want to feel or how you want others to feel. (your employees, your clients, your students, your children, your partner)
    – Get feedback and track progress towards the feeling goals by periodically measuring feelings from 0-10. For example, ask clients, students, teenagers how much they feel respected from 0 to 10.
    6. Feel energized, not angry.
    Use what others call “anger” to help feel energized to take productive action.
    7. Validate other people’s feelings.
    Show empathy, understanding, and acceptance of other people’s feelings.
    8. Use feelings to help show respect for others.
    How will you feel if I do this? How will you feel if I don’t? Then listen and take their feelings into consideration.
    9. Don’t advise, command, control, criticize, judge or lecture to others.
    Instead, try to just listen with empathy and non-judgment.
    10. Avoid people who invalidate you.
    While this is not always possible, at least try to spend less time with them, or try not to let them have psychological power over you.

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  • Art therapy brings comfort to Jordan’s orphans

    After a busy art session, the classroom at Amman’s al-Hussain Social Institution buzzed with energy, as children dashed around to clean up supplies, admire their paintings and pose in the decorated masks they designed.

    These young artists have come a long way over the past few months. Aged between six and 12, the children recently completed an art therapy programme – the first of its kind – designed to aid Jordan’s orphans. The weekly sessions of painting, gluing and building provided an atmosphere of organised chaos, during which they filled canvases with the anxieties and hopes that might otherwise be difficult to express.creatiggggvity

    “It’s like regular therapy, except you use art as a medium,” art therapist and programme founder Shireen Yaish told Al Jazeera. “It’s great for those who find it difficult to verbalise things – it’s about making the unconscious conscious, in a way. My job is to make people understand what they’re making.”

    As the weeks progressed, the children participating in this programme run by the Kaynouna Art Therapy Centre came out of their shells and developed great enthusiasm for their artwork, Yaish said. Supported by the al-Aman Fund for the Future of Orphans and the Abdul Hameed Shoman Foundation, the programme also exposed the profound needs of some of Jordan’s most vulnerable children. MORE HERE

  • Why Do We Get Addicted

    Think about an experience that makes you feel good. It could be successfully completing a project at work, eating a warm chocolate chip cookie or taking a swig of whiskey. It could be a puff of a cigarette or a shopping trip. A dose of Vicodin or a hit of heroin.

    Those experiences don’t automatically lead to addiction. So what makes a particular habit or substance an addiction? What propels some people to seek out these experiences, even if they are costly or detrimental to their health and relationships? Brain-0010.jpg

    “Addiction is a biopsychosocial disorder. It’s a combination of your genetics, your neurobiology and how that interacts with psychological and social factors,” said Maureen Boyle, a public health advisor and director of the science policy branch at the National Institute on Drug Abuse. That means it’s a lot like any other chronic disorder, such as type 2 diabetes, cancer and heart disease. And just like other chronic diseases, addiction is both preventable and treatable, Boyle said, but added that if left untreated, it can last a lifetime. [Do Smokers’ Lungs Heal After They Quit?]

    The mutual mechanism

    Though everyone’s path to addiction is different — whether he or she tries a drug or a behavior because it’s what that person’s parents or peer do, or just out of curiosity — what’s common across all substance and behavioral addictions is their stunning ability to increase levels of an important chemical in the brain called dopamine, Boyle told Live Science.

    Dopamine is a molecule that ferries messages across the brain’s reward center. It’s what gives people the feeling of pleasure and reinforces behaviors critical for survival, such as eating food and having sex.

    When someone uses a drug or engages in a pleasurable experience, the same natural reward circuitry is activated. “The problem with drugs is that they do the job better than natural rewards,” said Dr. Hitoshi Morikawa, an associate professor of neuroscience at the University of Texas at Austin.

    Different drugs tap into the dopamine reward system in different ways. Marijuana and heroin have a chemical structure similar to another neurotransmitter and can trick some brain cells into activating neurons that use dopamine. Cocaine and amphetamines, on the other hand, prolong the effect of dopamine on its target neurons, disrupting normal communication in the brain.

    How quickly each drug can get into the brain, and how powerfully it activates neural circuits, determines how addictive it will be, Morikawa told Live Science. Some modes of use, like injecting or snorting a drug, make the drug’s effects almost immediate. “That’s why heroin, for example, is the last drug you want to take,” he said. “It’s very addictive.”

    From experimenting to getting hooked

    As individuals continue with addictive habits or substances, the brain adapts. It tries to reestablish a balance between the dopamine surges and normal levels of the substance in the brain, Morikawa said. To do this, neurons begin to produce less dopamine or simply reduce the number of dopamine receptors. The result is that the individual needs to continue to use drugs, or practice a particular behavior, to bring dopamine levels back to “normal.” Individuals may also need to take greater amounts of drugs to achieve a high; this is called tolerance.

    Without dopamine creating feelings of pleasure in the brain, individuals also become more sensitive to negative emotions such as stress, anxiety or depression, Morikawa said. Sometimes, people with addiction may even feel physically ill, which often compels them to use drugs again to relieve these symptoms of withdrawal. [Booze Snooze: Why Does Alcohol Make You Sleepy, Then Alert?]

    Eventually, the desire for the drug becomes more important than the actual pleasure it provides. And because dopamine plays a key role in learning and memory, it hardwires the need for the addictive substance or experience into the brain, along with any environmental cues associated with it — people, places, things and situations associated with past use. These memories become so entwined that even walking into a bar years later, or talking to the same friends an individual had previously binged with, may then trigger an alcoholic’s cravings, Morikawa said.

    Brain-imaging studies of people with addiction reveal other striking changes as well. For example, people with alcohol-, cocaine- or opioid-use disorders show a loss in neurons and impaired activity in their prefrontal cortex, according to a 2011 review of studies published in the journal Nature Reviews Neuroscience. This erodes their ability to make sound decisions and regulate their impulses.

    Risk factors

    Some people are more susceptible to these extreme neurobiological changes than others, and therefore more susceptible to addiction. Not everyone who tries a cigarette or gets morphine after a surgery becomes addicted to drugs. Similarly, not everyone who gambles becomes addicted to gambling. Many factors influence the development of addictions, Boyle said, from genetics, to poor social support networks, to the experience of trauma or other co-occurring mental illnesses.

    One of the biggest risk factors is age. “The younger someone is, the more vulnerable they are to addiction,” Boyle said. In fact, a federal study from 2014 found that the majority (74 percent) of 18- to 30-year-olds admitted to treatment programs had started using drugs at age 17 or younger.

    Additionally, like most behavioral and mental health disorders, there are many genes that add to a person’s level of risk or provide some protection against addiction, Boyle said. But unlike the way in which doctors can predict a person’s risk of breast cancer by looking for mutations in a certain gene, nobody knows enough to be able to single out any gene or predict the likelihood of inheriting traits that could lead to addiction, she said.