Mindfulness and dissociation

I’m coping well with my ‘voices’ these days but still feel very ‘mindless’ and dissociated.

Dissociation and Mindfulness in Patients with Auditory Verbal Hallucinations.

The very few studies relating mindfulness and dissociation have found a negative association between them (depersonalization and absorption). However, all these studies have been done in non-clinical populations and there are no data on the relationship between these variables in psychiatric patients with auditory hallucinations. This study was designed to study the relationship between mindfulness and the two dissociative variables, absorption and depersonalization, as well as their predictive power for the severity of auditory hallucinations and the distress they cause in a clinical population. Fifty-five psychiatric patients with hallucinations were given the following tests: MAAS (Brown & Ryan, 2003), TAS (Tellegen & Atkinson, 1974), CDS (Sierra & Berrios, 2000), PSYRATS (Haddock, McCarron, Tarrier, & Faragher, 1999), and PANSS (Kay, Opler, & Lindenmayer, 1988). A significant negative correlation was found between mindfulness and the dissociative variables, and between mindfulness and the distress caused by the hallucinations. A positive correlation was also found between absorption and distress caused by hallucinations and between depersonalization and their severity. Finally, the variable with the most predictive power for severity of the voices was depersonalization, and the variable with the most predictive power for distress caused by the voices was mindfulness. Interventions addressing training in mindfulness techniques could diminish the distress associated with hearing voices.

Rufus May’s excellent site has interesting articles on mindfulness and dissociation.

I need to work on the following:

●    Acceptance – accepting what is present rather than denying it or wishing it was not there.
●    Non-judging – observing objects and events without evaluating them.
●    Patience – we stay with the present moment and don’t rush towards the next exciting event, we focus on the unique unfolding of what is happening now.
●    Beginners mind – seeing things with an open mind and noticing their unique qualities.
●    Letting go – developing the ability to switch attention and let go of one object of concentration and focus on another
●    Being with – as opposed to trying to fix or control things or achieve constantly
●    Non-striving – by accepting the present moment and its accompanying sensations we let go of constantly striving for better moments.  We focus on the journey rather than just the destination.
●    Non-attachment – this is about relating to things with kindness but not clinging onto them recognising that everything changes.

Mindfulness in schizophrenia: Associations with self-reported motivation, emotion regulation, dysfunctional attitudes, and negative symptoms.

Mindfulness and Metta-based Trauma Therapy (MMTT): Initial Development and Proof-of-Concept of an Internet Resource. 

Mindfulness & Metta Trauma Therapy (MMTT) is a self-help therapy for improving self-regulation in people suffering from trauma and stressor-related disorders that can be practiced online. The therapy was developed by Dr. Paul Frewen, a psychologist at Western University, Canada. MMTT involves learning to apply 6 therapeutic principles to your everyday life through the practice of a reflective journaling exercise we call Mindful and Metta Moments, as well as through the practice of guided meditations. The 6 therapeutic principles of MMTT are: 1) Presence, 2) Awareness, 3) Letting-Go, 4) Metta, 5) Re-Centering and De-Centering, and 6) Acceptance and Change.

Trauma and Stressor-related Disorders

Trauma and stressor-related disorders are psychological problems that are caused by the experience of one or more traumatic life events or relationships. Different researchers and clinicians define traumatic life events in different ways; some definitions are very broad and general, whereas others are more specific. For the purposes of this website, we define traumatic life events and relationships somewhat broadly as any life event or relationship that caused a person psychological harm that continues to be experienced long after the event occurred or the relationship ended. Examples of traumatic life events include:

  • rejection, abandonment or betrayal following the ending of a close and loving relationship;
  • experiences of complicated or extended grieving following the loss of a loved one (complicated bereavement);
  • being physically or sexually assaulted, or witnessing or finding out that this happened to another person you care about;
  • being verbally or emotionally abused or bullied, including as a child;
  • being abused, mistreated or neglected by caregivers when you were a child;
  • being in a life threatening or physically disabling event, for example, as in military combat, a serious car accident, or a fire, workplace accident or natural disaster;
  • experiences of guilt and shame for physical or psychological harm that you have caused another person.

Post-Traumatic Growth Follow Up: What It Takes To Grow From Tough Times

Compassion and the Voice of the Tormentor

See more at Voice Hearers Connect


A Neurophysiological and Neuropsychological Consideration of Mindful Movement: Clinical and Research Implications. (2015)

A Neurophysiological and Neuropsychological Consideration of Mindful Movement: Clinical and Research Implications.
In this article, we present ideas related to three key aspects of mindfulness training: the regulation of attention via noradrenaline, the importance of working memory and its various components (particularly the central executive and episodic buffer), and the relationship of both of these to mind-wandering. These same aspects of mindfulness training are also involved in the preparation and execution of movement and implicated in the pathophysiology of psychosis. We argue that by moving in a mindful way, there may be an additive effect of training as the two elements of the practice (mindfulness and movement) independently, and perhaps synergistically, engage common underlying systems (the default mode network). We discuss how working with mindful movement may be one route to mindfulness training for individuals who would struggle to sit still to complete the more commonly taught mindfulness practices. Drawing on our clinical experience working with individuals with severe and enduring mental health conditions, we show the real world application of these ideas and how they can be used to help those who are suffering and for whom current treatments are still far from adequate.

Main mindfulness instructions:

  • Awareness of sensations
  • Awareness of the present moment (PM)
  • Awareness of attention
  • Awareness of mind-wandering
  • Awareness of intention (on purpose)
  • Awareness of non-judgment

See the “Guidance for delivery of mindful movement for psychotic patients.

Third-wave strategies for emotion regulation in early psychosis: a pilot study (2015)

Third-wave strategies for emotion regulation in early psychosis: a pilot study

Aim: Emerging evidence supports the priority of integrating emotion regulation strategies in cognitive behaviour therapy for early psychosis, which is a period of intense distress. Therefore, we developed a new treatment for emotional regulation combining third-wave strategies, namely compassion, acceptance, and mindfulness (CAM) for individuals with early psychosis. The purpose of this study was to examine the acceptability, feasibility and potential clinical utility of CAM.

Method: A non-randomized, non-controlled prospective follow-up study was conducted. Outpatients from the First Psychotic Episode Clinic in Montreal were offered CAM, which consisted of 8-week 60–75 min weekly group sessions. Measures of adherence to medication, symptoms, emotional regulation, distress, insight, social functioning and mindfulness were administered at baseline, post-treatment and at 3-month follow up. A short feedback interview was also conducted after the treatment.

Results: Of the 17 individuals who started CAM, 12 (70.6%) completed the therapy. Average class attendance was 77%. Post-treatment feedback indicated that participants found the intervention acceptable and helpful. Quantitative results suggest the intervention was feasible and associated with a large increase in emotional self-regulation, a decrease in psychological symptoms, especially anxiety, depression, and somatic concerns, and improvements in self-care.

Conclusion: Overall results support the acceptability, feasibility and potential clinical utility of the new developed treatment. A significant increase in emotional self-regulation and a decrease in affective symptoms were found. No significant changes were observed on measures of mindfulness, insight, distress and social functioning. Controlled research is warranted to validate the effectiveness of the new treatment.

“…participants reported large improvements in regulating negative emotions (specifically self-blaming, rumination, and catastrophizing), and moderate to large improvements on affective symptoms (specifically depression, anxiety, and somatic concerns).”

Automatic thoughts may mediate the relationship between self-compassion and affect:

“…self-compassion and self-esteem increased positive automatic thoughts and decreased trait anxiety, whereas only self-esteem increased life satisfaction and decreased depression directly. Positive automatic thoughts increased life satisfaction and decreased depression and trait anxiety, and positive automatic thoughts mediated the relationship between self-compassion and negative affect. These findings suggest that both positive and negative automatic thoughts mediate the relationship between self-compassion and affect” [1]

fMRI studies have shed some light on the compassionate brain:

“…Imaging results showed that Compassion, relative to both passive-viewing and Reappraisal increased activation in regions involved in affiliation, positive affect and reward processing including ventral striatum and medial OFC. This network was shown to be active prior to stimulus presentation, suggesting that the regulatory mechanism of Compassion is the stimulus-independent endogenous generation of positive affect.” [2]

Similarly, Mindfulness Meditation has been studied:

“…recent functional imaging studies have identified the putative neurofunctional signatures of the change in the perspective on the self brought about by Mindfulness Meditation (MM). In particular, it has been claimed that during MM states detachment from identification with a static sense of self associates with a diminished self-referential, narrative/autobiographical, processing paired with enhanced present-based, experiential processing of the self. In the brain, this has been shown to reflect in decreased activity in self-referential cortical midline structures (e.g., medial prefrontal cortex) and enhanced activity in lateral structures such as the insula and the somatosensory cortex associated more with momentary interoceptive and exteroceptive self-awareness” [3]

Mindfulness meditation may also improve self-control via altered reward processing:

“…experienced mindfulness meditators are able to attenuate reward prediction signals to valenced stimuli, which may be related to interoceptive processes encoded in the posterior insula.” [4]

Cognitively-Based Compassion Training uses analytical and didactic techniques to reorient one’s perspective on his or her relationship with others. It is through this active analytical process and reorientation that empathy and compassion are cultivated. The instruction unfolds in the following order:

1: Developing Attention and Stability of Mind

2: Cultivating Insight into the Nature of Mental Experience

3: Cultivating Self-Compassion

4: Developing Equanimity

5: Developing Appreciation and Gratitude for Others

6: Developing Affection and Empathy

7: Realising Wishing and Aspirational Compassion

8: Realising Active Compassion for Others

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