Research Publications

Block, S. H., S. H. Ho, and Y. Nakamura. (2009). A Brain Basis for Transforming Consciousness with Mind-Body Bridging. Paper presented at Toward a Science of Consciousness Conference, June 12, at Hong Kong Polytechnical University, Hong Kong, China, Abstract 93.

Abstract

This presentation explores the brain basis of the transformation of consciousness and improved physical and mental functioning that result from a clinical intervention program, Mind-Body Bridging (MBB). The principles of MBB, developed by clinicians over the past ten years, appear strongly related to the teachings of many spiritual traditions. This paper will attempt to link the two main principles of MBB with the neuroscience and postulate brain mechanisms that account for the clinical benefits of MBB.

MBB teaches the patient to recognize and become aware of a dysfunctional mind-body state characterized by engrossment with self-centered thoughts (Storylines), involuntary contraction of awareness, body tension, and impaired mental and physical functioning. This is the state resulting from an overactive Identity System. Using written free-association exercises, called Mind-Body Mapping, the patient learns that Storylines are not random, but revolve around specific thoughts called “Requirements”, our ideas about how we and the world “should be” at each moment. Violations of these Requirements trigger the over-activation of the Identity System. MBB can teach the patient 1) how to rest his or her Identity System by Awareness Practices and 2) how to prevent the Identity System from being triggered by “Defusing” Requirements. When patients employ these MBB techniques, they rest the Identity System and automatically resume a mode of balanced and harmonious mental and physical functioning. Their awareness automatically expands to better embrace its adaptive role, when liberated from the harness of the Identity System to perceive reality as it is. Otherwise, the Identity System “moves into the drivers seat,” constricting consciousness by giving highest priority to fulfilling Requirements.

Neuroscience research has found two networks of functioning, executive network and default-mode network; they have different characteristics. The executive network dynamically regulates the mind in relation to the moment-by-moment situational goals, while the default-mode network stores life-long salient autobiographical memory used to construe one’s identity. It is postulated that if an event matches certain pre-existing conditions stored in the default network (Requirements), the network will respond with intense arousal and compulsivity. The activation of the default-mode network is accompanied by the deactivation of the executive network. Conversely, selective attention to a cognitive task or to sensory modalities (Awareness Practice) can activate the executive network and regulate the stress responses by inhibiting the default-mode network. Furthermore, the Mind-Body Mapping facilitates a new learning to rectify the invalid associations stored in the default-mode network. Taken together, these considerations help us link the corresponding states of 1) expansion and contraction of awareness and 2) resting and overactive Identity System with underlying brain mechanisms involved in MBB.

MBB carries the Awareness Practices one critical step further by addressing the cause for the resistances to clarity, i.e. afflictions caused by the Identity System. The awareness of the experiential and phenomenal aspects of the Identity System accounts for its therapeutic effectiveness, and clinical data will be presented. The transformation of consciousness that results from MBB is more aptly seen as a liberation of consciousness that has been constricted by the Identity System.

Tollefson, D. R., K. Webb, D. Shumway, S. H. Block, and Y. Nakamura. (2009). A Mind-Body Approach to Domestic Violence Perpetrator Treatment: Program Overview and Preliminary Outcomes. Journal of Aggression, Maltreatment, and Trauma, 18 (1),17-45.

Abstract

Conventional interventions with perpetrators of domestic violence are marginally effective. Given these results, researchers and practitioners are beginning to focus on identifying ways to improve domestic violence treatment outcomes. This article describes how a rural state-sponsored domestic violence offender program utilizes a treatment approach known as Mind-Body Bridging to help its clients overcome their abusive behaviors. Preliminary findings from an ongoing outcome study are also reported. According to these findings, the program has a high completion rate coupled with a low recidivism rate. Ninety-three percent (82 of 88) of the clients who have participated in this program completed the program, and just 7% (6 of 82) of those who completed the program reoffended during the follow-up period, which ranged from 9 to 27 months.

Nakamura, Y., D. L. Lipschitz, R. Landward, R. Kuhn, and G. West. (2011). Two Sessions of Sleep-Focused Mind-Body Bridging Improve Self-Reported Symptoms of Sleep and PTSD in Veterans: A Pilot Randomized Controlled Trial. Journal of Psychosomatic Research 70 (4): 335-45.

Abstract

Objectives. Sleep disturbance is highly prevalent among veterans. As an alternative to sleep medications with their undesirable side effects, nonpharmacological mind–body interventions may be beneficial for sleep management in primary care. The aim of this pilot study was to investigate whether a novel mind–body intervention, mind–body bridging (MBB), focusing on sleep, could improve self-reported sleep disturbance and comorbid symptoms in veterans.

Methods. This pilot study was a randomized controlled trial at the Veterans Affairs Salt Lake City Health Care System in which 63 veterans with self-reported sleep disturbance received MBB or an active sleep education control. Both interventions were conducted in two sessions, once per week. Patient-reported outcomes included the following: primary—Medical Outcomes Study (MOS) Sleep Survey, MOS Short Form-36V; secondary—Center for Epidemiological Studies–Depression, PTSD Check List–Military, Five-Factor Mindfulness Questionnaire.

Results. At both Week 1 (1 week after the first session) and post-intervention assessments, while sleep disturbance decreased in both groups, MBB performed significantly better than did the control group. Furthermore, self-reported PTSD symptoms improved in MBB, while they remained unchanged in the control. Overall mindfulness increased in MBB, while it remained unchanged in the control.

Conclusions. This study provides preliminary evidence that a brief sleep-focused MBB could be a promising intervention for sleep and potentially other comorbid symptoms (e.g., PTSD). MBB could help patients develop awareness skills to deal with sleep-related symptoms. Integration of MBB into primary care settings may enhance care of patients with sleep disturbance and co-morbid symptoms.

Nakamura, Y., D. L. Lipschitz, R. Kuhn, A. Y. Kinney, and G. W. Donaldson. (2013). Investigating Efficacy of Two Brief Mind-Body Intervention Programs for Managing Sleep Disturbance in Cancer Survivors:  A Pilot Randomized Controlled Trial. Journal of Cancer Survivorship 7 (2): 165-82.

Abstract

Purpose. After completing treatment, cancer survivors may suffer from a multitude of physical and mental health impairments, resulting in compromised quality of life. This exploratory study investigated whether two mind–body interventions, i.e., Mind–Body Bridging (MBB) and Mindfulness Meditation (MM), could improve posttreatment cancer survivors’ self-reported sleep disturbance and comorbid symptoms, as compared to sleep hygiene education (SHE) as an active control.

Methods. This randomized controlled trial examined 57 cancer survivors with clinically significant self-reported sleep disturbance, randomly assigned to receive MBB, MM, or SHE. All interventions were conducted in three sessions, once per week. Patient-reported outcomes were assessed via the Medical Outcomes Study Sleep Scale and other indicators of psychosocial functioning relevant to quality of life, stress, depression, mindfulness, self-compassion, and well-being.

Results. Mixed effects model analysis revealed that mean sleep disturbance symptoms in the MBB (p = .0029) and MM (p = .0499) groups were lower than in the SHE group, indicating that both mind–body interventions improved sleep. In addition, compared with the SHE group, the MBB group showed reductions in self-reported depression symptoms (p = .040) and improvements in overall levels of mindfulness (p = .018), self-compassion (p = .028), and well-being (p = .019) at postintervention.

Conclusion. This study provides preliminary evidence that brief sleep-focused MBB and MM are promising interventions for sleep disturbance in cancer survivors. Integrating MBB or MM into posttreatment supportive plans should enhance care of cancer survivors with sleep disturbance. Because MBB produced additional secondary benefits, MBB may serve as a promising multipurpose intervention for posttreatment cancer survivors suffering from sleep disturbance and other comorbid symptoms.

Implications for Cancer Survivors. Two brief sleep-focused mind–body interventions investigated in the study were effective in reducing sleep disturbance and one of them further improved other psychosocial aspects of the cancer survivors’ life. Management of sleep problems in survivors is a high priority issue that demands more attention in cancer survivorship.

Lipschitz, D. L., R. Kuhn, A. Y. Kinney, G. W. Donaldson, and Y. Nakamura. (2013). Reduction in Salivary Alpha-Amylase Levels Following a Mind-Body Intervention in Cancer Survivors. Psychoneuroendocrinology 38 (9): 1521-31.

Abstract

Objective. The main aim of this exploratory study was to assess whether salivary α-amylase (sAA) and salivary cortisol levels would be positively modulated by sleep-focused mind–body interventions in female and male cancer survivors.

Methods. We conducted a randomized controlled trial in which 57 cancer survivors with self-reported sleep disturbance received either a Sleep Hygiene Education (SHE; n = 18) control, or one of two experimental mind–body interventions, namely, Mind–Body Bridging (MBB; n = 19) or Mindfulness Meditation (MM; n = 20). Interventions were three sessions each conducted once per week for three consecutive weeks. Saliva cortisol and sAA were measured at baseline and 1 week after the last session. Participants also completed a sleep scale at the same time points when saliva was collected for biomarker measurement.

Results. Our study revealed that at post-intervention assessment, mean sAA levels upon awakening (“Waking” sample) declined in MBB compared with that of SHE. Mean Waking cortisol levels did not differ among treatment groups but declined slightly in SHE. Self-reported sleep improved across the three interventions at Post-assessment, with largest improvements in the MBB intervention.

Conclusion. In this exploratory study, sleep focused mind–body intervention (MBB) attenuated Waking sAA levels, suggesting positive influences of a mind–body intervention on sympathetic activity in cancer survivors with sleep disturbance.

Nakamura, Y., D. L. Lipschitz, E. Kanarowski, T. McCormick, D. Sutherland, and M. Melow-Murchie. (2015).  Investigating Impacts of Incorporating an Adjuvant Mind-Body Intervention Method Into Treatment as Usual at a Community-Based Substance Abuse Treatment Facility: A Pilot Randomized Controlled Study. SAGE Open 5 (1): 2158244015572489.

Abstract

Treatment of substance use/misuse (SUM) continues to pose a difficult challenge. This exploratory pilot study evaluated whether a novel mind–body intervention program called “Mind–Body Bridging” (MBB) could be an effective short-term adjuvant intervention for managing SUM and coexisting symptoms in women undergoing residential and outpatient substance use treatment in a community setting. Thirty-eight women attending a local substance abuse (SA) facility were recruited and randomly assigned to either (a) treatment as usual (TAU) or (b) MBB and TAU. The MBB program consisted of 20 sessions and lasted for 10 weeks. Participants were asked to complete a set of self-report questionnaires designed to assess drug/alcohol cravings, impact of past trauma, depression, sleep disturbance, mindfulness, self-compassion, and well-being. They completed the questionnaires at three time points: preintervention, midintervention (after the fifth week), and postintervention. MBB + TAU significantly reduced drug/alcohol cravings, trauma-related thinking, and disturbed sleep in comparison with TAU. Furthermore, MBB + TAU significantly increased mindfulness, self-compassion, and well-being in comparison with TAU. MBB for SUM appears promising as a complementary adjuvant intervention, warranting future larger scale randomized controlled trials of MBB for SUM populations. SUM is a difficult condition to treat and manage clinically, especially given the multiple comorbid conditions that frequently affect those with SUM. In the search to develop effective adjuvant interventions for SUM, the present pilot study suggested that adding MBB to standard SUM treatment in community-based settings could enhance therapeutic efficacy and quality of care.

Lipschitz, D.L., Kuhn, R., Kinney, A.Y., Grewen, K., Donaldson, G.W., and Nakamura, Y. (2015). An Exploratory Study of the Effects of Mind-Body Interventions Targeting Sleep on Salivary Oxytocin Levels in Cancer Survivors. Integrated Cancer Therapies, 14(4), 366-80.

Abstract

Cancer survivors experience high levels of distress, associated with a host of negative psychological states, including anxiety, depression, and fear of recurrence, which often lead to sleep problems and reduction in quality of life (QOL) and well-being. As a neuropeptide hormone associated with affiliation, calmness, and well-being, oxytocin may be a useful biological measure of changes in health outcomes in cancer survivors. In this exploratory study, which comprised a subset of participants from a larger study, we evaluated (a) the feasibility and reliability of salivary oxytocin (sOT) levels in cancer survivors and (b) the effects of 2 sleep-focused mind–body interventions, mind–body bridging (MBB) and mindfulness meditation (MM), compared with a sleep hygiene education (SHE) control, on changes in sOT levels in 30 cancer survivors with self-reported sleep disturbance. Interventions were conducted in 3 sessions, once per week for 3 weeks. Saliva samples were collected at baseline, postintervention (~1 week after the last session), and at the 2-month follow-up. In this cancer survivor group, we found that intra-individual sOT levels were fairly stable across the 3 time points, of about 3 months’ duration, and mean baseline sOT levels did not differ between females and males and were not correlated with age. Correlations between baseline sOT and self-report measures were weak; however, several of these relationships were in the predicted direction, in which sOT levels were negatively associated with sleep problems and depression and positively associated with cancer-related QOL and well-being. Regarding intervention effects on sOT, baseline-subtracted sOT levels were significantly larger at postintervention in the MBB group as compared with those in SHE. In this sample of cancer survivors assessed for sOT, at postintervention, greater reductions in sleep problems were noted for MBB and MM compared with that of SHE, and increases in mindfulness and self-compassion were observed in the MBB group compared with those in SHE. The findings in this exploratory study suggest that sOT may be a reliable biological measure over time that may provide insight into the effects of mind–body interventions on health outcomes in cancer survivors.