Mind over mind

Stay calm and focused with mindfulness meditation.

by Aviva Patz

By the time Sarah Hamilton, of Washington, Connecticut, was diagnosed with multiple sclerosis in 2002, she’d been practicing a type of mindfulness meditation for over a decade. And it was that training that kept her from freaking out. “I was able to see it as more of a revelation,” says Hamilton, a certified life coach. “I could breathe, take a step back, and not drown in the emotion, the fear, the trauma. I could stay tuned into what was actually going on at that time.”

Hamilton’s experience illustrates some of the potential benefits of mindfulness meditation now being explored for people living with MS. A recent pilot study of people with MS, conducted at Ohio State University, compared the results of a four-week, mindfulness meditation-based attention training program with a type of cognitive training as well as a control group. The results are “very encouraging and could improve mood and cognition for people with MS,” says Ruchika Prakash, PhD, co-author of the study and Ohio State University associate professor of psychology. The National Multiple Sclerosis Society funded the research.

What is mindfulness?
According to John Kabat-Zinn, a pioneer in bringing mindfulness-based stress reduction to the mainstream, mindfulness involves “paying attention on purpose, without judgment, in the present moment and with a kind and compassionate awareness.”

For Prakash, that means cultivating focused attention. “Intention is really important,” she says. “When you focus on the present moment, sometimes it isn’t good — especially for people with MS who may be working with all sorts of limitations,” she says. It’s also essential to cultivate an attitude of acceptance, non-judgment and being patient with yourself. For example, if a doctor gives you bad news, and then your brain goes off imagining worst-case scenarios, you can no longer focus. “With mindfulness training, you can say, ‘Yes, it’s bad news, but I need to hear what my neurologist is saying,’ ” Prakash says.

Reasons for the study
The inspiration for this study came from a casual conversation between Prakash and a person with MS about how fitness may improve processing speed for people with MS. “I was working with a woman in a wheelchair who didn’t feel she could take on an intense exercise regimen,” Prakash recalls. At the time, there were a lot of research studies coming out on mindfulness, showing promise for problems such as depression and anxiety, loneliness, inflammation, pain, lack of focus and negative moods. “Once I got my position at Ohio State, I wanted to study it more systematically,” she says, “so we started looking at mindfulness meditation and how it impacts cognitive and emotional health.”

Although symptoms can vary widely, many people with MS report emotional and cognitive difficulties, such as changes in memory and speed of thought processing. “People with MS may have a challenging time managing their emotions — 1 in 2 has some symptoms of anxiety and depression,” Prakash says. “Since emotional dysregulation — that is, patterns of emotional experience and expression that interfere with goal-directed behavior — underlies other psychiatric disorders, we wanted to identify a factor that could help people cope with both issues.”

Many people with MS also experience chronic pain, and emotional distress can compound it. “More often than not, when we experience a powerful sensation, we’re not feeling that sensation, but rather, we’re dwelling on the narrative about it,” Prakash explains. She cites the example of someone whose chronic pain was wrapped up in memories of a car accident. “He relived the trauma of the accident every time he had pain,” she says. “Once he was able to separate the pain from the narrative, he could manage it better.”

Mindfulness meditation has changed how Hamilton handles pain. “If I judge the pain to be bad, it’s worse,” she says. “Stripping out the emotional quality of the pain — the drama, the haranguing, the ‘woe is me’ — helps me get through it more easily.”

The study
For the study, researchers placed 61 people with MS into one of three groups: mindfulness training, adaptive cognitive training, or a control group that received no treatment until after the study. Both training groups met for two hours a week for four weeks and did an extra 40 minutes of practice at home on the other six days of the week.

The mindfulness training program involved cultivating breath awareness, engaging in mental “body scans,” a meditative practice designed to focus attention and sensory awareness of various body parts, and practicing sitting meditation, with an emphasis on thoughts, emotions and sensations.

The cognitive training program, done on a computer, involved:

• Training in processing speed (how fast you can respond to stimuli)
• Attention (ability to focus on what’s relevant to the task at hand and filter out what’s irrelevant)
• Executive function (higher-order skill that includes planning and multitasking, organizing)
• Working memory (involving the manipulation of information in the mind)

Participants filled out surveys at the beginning and end of the study asking them to rate their agreement with statements such as, “If I find myself in a chaotic situation, I can manage my emotions,” or “I experience my emotions as overwhelming and out of control.” They also did paper-and-pencil tasks assessing specific thinking skills.

Results of the study
After four weeks, participants in the mindfulness meditation group reported significant improvements in their ability to manage their negative emotions, compared to the other two groups.

They also reported marked improvements in processing speed — the time it takes to understand and react to information — compared to the other groups. “Processing speed or the ability to respond quickly to incoming information is one important domain impacted in people with MS,” Prakash says. “We were somewhat surprised but excited to see this training intervention that we thought would mostly impact emotion regulation also improve processing speed.”

Because it’s only a pilot study with 60 people, “we can’t say it will apply to everybody,” Prakash adds. “But the data is promising evidence that mindfulness training can help MS patients deal with their emotions more constructively and positively, and improve some elements of cognition.”

Follow-up studies planned
Prakash and her team are now testing ways to make the training more accessible. In the meantime, they have hosted mindfulness webinars and posted free instructional videos on a YouTube channel (bit.ly/MindBody_OSU). “Anyone can use mindfulness — even people with limited mobility,” Prakash says, circling back to the whole reason she began the investigation.

A practice of just 15 to 20 minutes a day could change your life. “It’s the best gift I ever gave myself,” Hamilton says. “Just be patient because it doesn’t happen overnight.”

Aviva Patz is a writer in Montclair, New Jersey.

To find meditation resources, contact an MS Navigator by calling 1-800-344-4867, emailing ContactUsNMSS@nmss.org or visiting nationalMSsociety.org/navigator.