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Mindfulness Based Practices and PTSD

5/27/2018

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Tai chi as a mindfulness-based practice has powerful applications for dealing with post traumatic stress disorder (PTSD). Relevant elements of Mind/Body training, rooted in Zen practice, includes Mushin (No-Mind), which in East-West psychology can be translated as mindfulness from “emptiness.” The idea is that to become mindful, you first have to become an empty vessel (a great tool for dealing with past trauma and abuse). It is easier to not be haunted or tormented by the past, if you live in the moment (i.e. “Mindfulness”), empty of the past. Other critical concepts include developing control of the “Monkey Mind” (random and destructive thoughts). In Zen, a comparison of the untrained mind is made to a monkey, which runs from one distraction to another. Or in the mind’s case, from one thought to another. And this includes destructive thoughts. Give the monkey something to focus on (a shiny bobble for example), and it sits still, entranced. Focusing the mind on the ten count in sitting meditation, or on the leading hand in Tai Chi, has a similar effect on the mind. Focusing the mind stills random and sometimes destructive or depressive thoughts. Another analogy used in Zen is “Taming the Ox.” To make an ox useful, a ring is placed through the nose. Otherwise the ox is difficult to control (the “Bull in the China Shop”). Meditative practices is the ring in the nose of an ox for the human mind. It makes the mind a powerful ally. This is related to the goal of the development of superior focus (Isshin, One Mind). Training the mind through Mind/Body practices frees the mind from trauma, as well as doubt, fear and anxiety. They are seen as paths to Kensho from the Japanese Zen tradition (Self-Nature/Self-Realization, or in other words, enlightenment). The Sanskrit word for this is Bodhi. Bodhi-dharma’s name (the father of Zen/Chan and Shaolin Kung Fu) translates as “Enlightenment teacher/teaching”. Essentially using a physical practice to train the mind. As such, exercises such as Tai Chi are ideal for this.
 
Awareness (Sati in the Buddhist tradition) is a major component in Zen therapy, developed as a means for eliminating destructive behavior and thoughts. Psychologist Jon Kabat-Zinn has translated this as “Mindfulness,” and used this concept to create a very powerful tool for Mindfulness Based Stress Reduction. Meditation can be used as a tool to develop awareness of destructive habits and reactions, and to enhance identification of cues triggering negative behavior, including PTSD. Essentially a mental “stepping back,” allowing space for action free from the past, as opposed to uncontrolled, destructive, and unconscious reaction. Focusing on the leading hand during Tai Chi can help develop a “blank slate” for in the moment mindfulness.
 
Everyday stress, as well as PTSD, are both physiological responses as well as a mental reaction. Enhanced awareness, coupled with the discipline developed from daily practice, and the benefits of exercise, can short-cut stress responses, permitting greater control and mastery over life. Focusing the mind on the movements in Tai Chi places the mind in a relaxed state beyond thought, which can break vicious cycles of trauma, stress and worry. Tai Chi and other exercises (including aerobic forms of exercise, such as running) also stimulate natural production of endorphins and endocannabinoids, which work on receptors in the body stimulating an effect similar to opioids (opium) and cannabis (marijuana), but without the dangerous side effects or addictive properties of drugs.
 
Dr. Kim and colleagues with the University of New Mexico conducted a literature review on the benefits of Mind/Body practices for PTSD. The authors concluded from the review that these exercises can have a positive impact on PTSD symptoms by having a therapeutic effect on the stress response, including reduction in anxiety, depression, and anger. The review also identifies benefits related to increases in pain tolerance (which may be due to elements discussed above), self-esteem, energy levels, ability to relax, and ability to cope with stressful situations. The authors state that Mind/Body practices (including Tai Chi, Qigong, Yoga and other modalities) can be a valuable method for dealing with intrusive memories, avoidance, and increased emotional arousal.
 
Doctor Longacre and colleagues, with the Boston University School of Public Health, also conducted a scientific review of literature on relevant complementary and alternative medicine (CAM). Tai Chi and Qigong were noted as being particularly effective practices. These exercises produced statistically significant improvements in psychological wellbeing. This included reductions in mood disturbance, anxiety, stress, tension, depression, anger, fatigue and confusion. The authors stated that Qigong and Tai Chi demonstrated particular promise in their ability to provide relief of psychological and psychosomatic aftereffects resulting from torture. It is suggested that the increase in bodily awareness and mental focus may aid survivors of torture in overcoming the physiological impact of trauma, while addressing various symptoms characteristic of PTSD. The researchers further noted that Mind/Body practices may be particularly effective compared to conventional medical treatments. This is supported by case story statements posted on the Metarobics Facebook page in May in honor of  Memorial Day.
 
Another study conducted at the Boston School of Medicine looked specifically at Qigong and Tai Chi as a therapeutic intervention for survivors of torture and refugee trauma. The researchers presented case stories from four refugee survivors of torture, who used a simplified Qigong and Tai Chi practice to deal with PTSD. Participants reported that the exercises helped develop calmness; increase control over external stimuli, to prevent triggering re-experiencing episodes; improvement in pain at sites of torture-related injuries; decrease in flashbacks; less reported anxiety and stress; and an improvement in mood.
 
The above study also further supports the importance of developing a physiological and psychological understanding of these exercises (whether Metarobic or otherwise). The researcher’s noted that some benefits may be due to Qigong and Tai Chi as methods of cultivating and balancing the flow of internal energy. The attribution of benefits to internal energy is frequent even in the scientific literature on medical benefits, due to the roots of these exercises in traditional practices. This “Qi” as “energy work” perspective can lead to valuable directions for research. But to truly create interest in the medical community and the in the public, it is also important to identify physiological and psychological effects underlying the benefits of these exercises, which is one of the goals of my research.
 
References
 

Kim SH, Schneider SM, Kravitz L, Mermier C, Burge MR. Mind-body practices for posttraumatic stress disorder. J Investig Med. 2013 Jun;61(5):827-34.
 
Longacre M, Silver-Highfield E, Lama P, Grodin M. Complementary and alternative medicine in the treatment of refugees and survivors of torture: a review and proposal for action. Torture. 2012;22(1):38-57.
 
Grodin MA, Piwowarczyk L, Fulker D, Bazazi AR, Saper RB. Treating survivors of torture and refugee trauma: a preliminary case series using qigong and t'ai chi. J Altern Complement Med. 2008 Sep;14(7):801-6. 

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