你能负担不起冥想吗?从肝硬化的正念疗法中学到的教训

基于正念的冥想起源于2个世纪以前的亚洲佛教传统,旨在增加关注并提高对当前时刻的非判断性意识。一个最近的研究出版于临床和转化胃肠病学旨在确定基于冥想的实践可能影响肝硬化患者及其护理人员的生活质量的方式。

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基于正念的压力减轻

在基于正念的压力减轻(MBSR)中,人们学会停止所谓的“猴子大脑”。就像丛林中的猴子从分支跳到分支一样,我们在任何给定的时刻都从一个想法转移到另一个想法。这种情况如此迅速,以至于在某些情况下,我们甚至都不知道我们的内部对话。这些自动思想可能涉及反思我们在特定情况下的表现或应该如何表现。我们也可能担心将来我们不会满足我们或其他人的期望。这种负面思维会导致抑郁,焦虑,沮丧,恐惧和愤怒。或简单地说,痛苦。最重要的是,这些想法阻止了我们现在生活,并“正念”。

To stop this negative habit, you can use, for example, the body scan meditation. This technique literally forces you to stay focused on the present by channeling one thought at a time. If you force your brain to focus on the sensations of, for example your foot, you cannot simultaneously daydream about your life’s unpleasantries. Nowadays, you can download an MBSR app to your phone, listen to them streamed over the Internet, or buy a CD. However, turning these experiences into positive outcomes to reduce suffering in chronic diseases is a worthy goal because of the physical suffering that is magnified by emotional and mental suffering. Current medical treatments are aligned towards physical symptoms and are not focused on the other aspects of suffering for the patients and their caregivers.

MBSR减轻疾病负担

在具有高组合疾病负担(例如纤维肌痛和慢性背痛)的疾病中,冥想练习可以减轻情绪痛苦,甚至可以改善大脑功能。

在具有高组合疾病负担(例如纤维肌痛和慢性背痛)的疾病中,冥想练习可以减轻情绪痛苦,甚至可以改善大脑功能。为了更好地了解MBSR如何改善思维方式,科学家正在使用复杂的脑成像工具,例如功能磁共振成像(fMRI)。这些显示冥想实践后大脑区域之间的联系更强。

Given the notion that meditation reduces emotional suffering, we decided to test MBSR in people suffering from cirrhosis, an epidemic medical disorder worldwide which is usually caused by obesity, diabetes, alcohol, and hepatitis. Cirrhosis affects several organs in addition to the liver, and a major impact is felt on the brain. This disease process starts by an inability to pay attention and can lead to serious mental problems such as disorientation, confusion and coma. This is further complicated by a strong overlay of depression which is often inadequately treated because clinicians can be afraid of maximizing medication dosages in patients with diseased livers (as the liver is responsible for clearing these medications). This disease therefore results in an untreated mental and emotional patient burden, a burden on the medical system, and a large burden on their companions or caregivers.

用MBSR治疗肝硬化患者及其护理人员

MBSR had never been studied in patients with cirrhosis. We also wanted to clarify whether MBSR techniques could reduce caregiver-illness related burden. Therefore, to be included in our study, the patients suffering from cirrhosis were, at a minimum, mildly depressed (as measured by the Beck Depression Inventory-II), and also had a caregiver willing to participate in the MBSR training. Ultimately, 20 couples enrolled in the study.

Couples participated in four 1-hour group therapy sessions. MBSR specific techniques used at each session included the body scan, progressive muscle relaxation, and the loving kindness meditation along with the gentle movements of Qigong. Each patient and their significant other were given a CD to take home so that they could practice the techniques on a daily basis. Patients recorded doing the MBSR techniques between group therapy sessions so that we could guarantee that they practiced what they learned in therapy.

MBSR改善生活质量

在研究的开始和结束时,患者及其护理人员均填写了评估抑郁症,睡眠质量和整体与健康相关的生活质量的验证问卷。为了最大程度地减少研究作者对该主题的问卷的影响的潜力,该项目的第一和高级作者都不参与进行每周MBSR小组治疗课程或管理心理问卷。有趣的是,在MBSR培训月底的肝病患者的睡眠卫生及其与健康相关的生活质量(即抑郁症的减少)方面有了显着改善。该项目还与照料者负担大大减轻有关。该数据表明,仅在慢性疾病(如肝肝硬化)中即使在慢性疾病中,也只有一个月的MBS计划显着改善了患者报告的结果和护理人员负担。

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Comment

Elizabeth Garland

我有hep c,很想在接受治疗之前参加。实际上,在治疗期间和/或治疗后也将进行出色的研究。

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