Mindfulness and Meditation for Diabetes Management
Last night my thoughts returned again and again to a missing package. The sender had written me that my order had been delivered, but I hadn't received it. I tried and tried to suppress that thought and to get back to sleep. Finally, meditation helped.
This was for me a painful example of what psychologists call "thought suppression." Like many people, I have experienced thought suppression lots of times. But I don't remember having read about this concept before starting to prepare this article, which reviews a new study of how meditation and mindfulness can help people with diabetes and other long-term conditions.
Participants in the study "reported significant reductions in worry and thought suppression." I knew about worry, but I had to look up "thought suppression."
It turns out that some people have been thinking about thought suppression for years. Back in 1863 the Russian novelist and philosopher Fyodor Dostoyevsky wrote about it in Winter Notes on Summer Impressions:
"Try to pose for yourself this task: not to think of a polar bear, and you will see that the cursed thing will come to mind every minute."
When a psychology professor at Harvard University named Daniel Wegner came across that quotation in the 1980s, he decided to test it with a simple experiment, as Lee Winerman reported:
Dr. Wegner asked participants to verbalize their stream of consciousness for five minutes, while trying not to think about a white bear. Despite his explicit instructions to avoid it, the participants averaged more than one white bear thought per minute.
Then he asked them to do the same exercise, but this time to try to think about a white bear. Now the participants thought about a white bear even more often than a different group of participants, who had been told from the beginning to think of white bears. The results suggested that suppressing the thought for the first five minutes caused it to "rebound" even more prominently into the participants' minds later.
This research started a brand new field of study. Dr. Wegner later developed the "White Bear Suppression Inventory."
The new study that I am reviewing here used it to measure how much the participants tried to suppress negative thoughts about their condition before and after the meditation and mindfulness programs (the researchers used the Penn State Worry Questionnaire to measure worry).
But how do you stop thinking about a white bear? This simple question doesn't have an easy answer. But a few years ago Dr. Wegner suggested that meditation and mindfulness could help.
When we get a diagnosis of diabetes, it can cause us considerable distress. The participants in the new study regularly talked about the shock, the uncertainty, the fear of unexplained physical symptoms, and of their social isolation. Some of them begin to obsess about their health problems.
Meditation and mindfulness seems to be particularly useful when we first learn that we have diabetes or right after a serious event. That's when anxiety, worry, and thought suppression can become serious threats to our health.
The new study by British researchers appears in the current issue ofBehavioral Medicine. The researchers pilot-tested a six-week meditation and mindfulness intervention in 40 people, 20 of whom have diabetes. This program encouraged participants to engage in non-judgmental self-observation leading to a greater understanding and awareness of their thoughts, actions, and emotions.
The training that these participants received led them to a more balanced and accepting view of their illness and of their experience with it. They focused better on the present, stopped obsessing about the past, and voiced less concern about the future.
When we meditate, we usually relax and are less stressed. But this isn't its goal. Instead, mediation teaches us mindfulness, focusing our attention on the here and now while cultivating openness, curiosity, and acceptance.
Meditation and mindfulness skills do led to improved sleep, greater relaxation, and more-accepting approaches to illness and illness experience. At the end of the meditation course worry and thought suppression which earlier studies showed are associated with depression among people with long-term conditions were significantly reduced. Thought suppression has also been previously known to predict the onset and continuation of anxiety and mood disorders.
Mindfulness can stop negative thoughts from impacting our mood. It is based on a form of meditation practice known as Insight Meditation, which is the form that I have practiced for several years.
The meditation and mindfulness program incorporated three techniques:
1. Sitting meditation, using the breath as the point of focus.
2. Walking meditation to develop awareness of movement.
3. Body awareness, where the participants systematically focused their attention on all parts of the body to develop awareness of sensations.
The new study is the first one that demonstrated that a meditation and mindfulness program can reduce worry and thought suppression in people with diabetes. However, three earlier studies showed how meditation and mindfulness can help people with diabetes cope in other ways:
1. The DiaMind study in the April 2013 issue of Diabetes Care found in a randomized trial that "patients receiving MBCT [Mindfulness-Based Cognitive Therapy] showed significantly larger decreases in perceived stress, symptoms of depression and anxiety, and had significantly better improvements in health-related quality of life compared with those in [the usual care] group."
2. A Mindfulness-based Stress Reduction study of people with type 2 diabetes in the May 2012 issue of Diabetes Care by researchers at the University of Heidelberg "achieved a prolonged reduction in psychosocial distress."
3. Another Mindfulness-based Stress Reduction study, this one by researchers at Philadelphia's Thomas Jefferson University and reported in the September-October 2007 issue of Alternative Therapies in Health and Medicine, included only 14 participants. But they had a statistically significant reduction in their A1C levels and were less depressed, anxious, and distressed than at the beginning of the study.
The new study is non-experimental and didn't have a control group. Its purpose was mostly to look at the issues of acceptability and feasibility, and it served that purpose well. Together with the three earlier studies, we now have a body of evidence showing that meditation and mindfulness for the management of our diabetes really can help.