A new study shows few mental health apps are opened beyond 15 days after their download. This new insight raises the question, ‘how much do we know about the benefits of one to many mental health approaches?’.
A new study exploring mass self-treatment (MST) mental health technologies has indicated that although there are a large number of MST apps in widespread use, people rarely engage with them for more than a fortnight1. The available evidence raises important questions about the deployment of clinically-led meditation and mindfulness technologies. For example, what is the most beneficial context in which meditation should be practiced?
It has long been imagined that the growing use of apps would eventually lead to improved support for people experiencing problems with mental health. That the proliferation of MST technologies would lead to a ‘new age’ of health and wellbeing. But, the role of social isolation in declining mental health2 is well known and reliably documented. And although mental health apps offer access to both resilience building and treatment methods, they tend to lend themselves to isolated rather than group practice. So alongside the benefits of cost and flexibility through one-to-many mental health apps, the possible loss of the social engagement from face to face contact must be considered. I’ve seen no clear evidence that practising meditation and mindfulness through an app is more or less beneficial than traditional group practice. There is little replicated research in this regard. But we do know that a sense of social isolation can lead to limitations in brain functions, irregular sleep patterns and lower levels of physical and mental health.
“The key message of this latest research is that humans are complicated, both in terms of their mental health and its treatment. Given the potential reach of ‘one size fits all’ approaches, reliable, replicated research should be a foundational principle in the development of health apps.”
Stephen Gene Morris
The science supporting the long term use of MST mental health technologies is of a preliminary nature. More work needs to be undertaken regarding the benefits of using apps to support mental health. But perhaps comparative studies focusing on MST and face to face interventions should be seen as a high priority. However, as a general principle, engaging with any MST approach likely to increase a feeling of social isolation should be considered carefully.
1 Baumel, A., Muench, F., Edan, S., & Kane, J. M. (2019). Objective User Engagement With Mental Health Apps: Systematic Search and Panel-Based Usage Analysis. Journal of medical Internet research, 21(9), e14567.
2 Cacioppo, J. T., & Cacioppo, S. (2014). Social relationships and health: The toxic effects of perceived social isolation. Social and personality psychology compass, 8(2), 58-72.
Many scientists claim that mindfulness is both a ‘non-judgemental’ approach and holds congruence with Buddhist forms of meditation. Are these two positions mutually exclusive?
Mindfulness has attracted sustained criticism from within the scientific community over the last few years. Claims that the science supporting mindfulness lacks a reliable evidential base are growing. In addition, religious scholars1 and traditional meditation practitioners have discussed the implications of the lack of judgement or ethical frameworks, closely associated with some mindfulness practices.
In a recent article2 a leading Buddhist teacher from the Tibetan Nyingma tradition, Chokyi Nyima Rinpoche, has stressed the need for meditation to be seen in a relevant ethical context. Rinpoche talks about not ‘blindly meditating’, that our meditation should be directed by study and understanding. Although these points are being made from a Buddhist perspective, their relevance can apply to both secular and spiritual meditation practices. Psychologically speaking, meditation and mindfulness are simply forms of brain training, changes in behaviour leading eventually to functional and structural modifications in the brain. So if your meditation practice is based on reducing judgement of the reality of your day to day life, this is likely to be the result of the practice. Developing an understanding of why you are meditating and what it means in the real world, ensures your practice has direction and is relevant to you.
“We can’t just blindly meditate”
Chokyi Nyima Rinpoche
Practicing with forms of meditation that lack any coherent ethical or judgemental context may lead to a reduction of reasoning and introspection, two functions linked to essential intrinsic network activity in the brain. Whilst it can be acknowledged that non-judgemental practices are common in Buddhism, they are always set within a wider ethical framework. The points Chokyi Nyima Rinpoche made, are consistent with my own understandings of the science of mindfulness and meditation. That self-transformation (the goal of meditation technologies), requires a sound theoretical framework to be successful. A sound theoretical framework would include an explanation of our being (the ontology that supports meditation) and an understanding of the effectiveness of the methods used (epistemology).
There are no restrictions of the forms of meditation that can be created and practiced, and there is evidence that mindfulness may be able to deliver some benefits. But based on the available data, it may be that meditation practices that are not embedded in stable frameworks might deliver unpredictable results. Not simply because ethical frameworks are in some way morally advantageous, but for the reason that they create the conditions where the practice becomes embedded in both the meditation student and the real world. I would suggest that anything less, risks strengthening dualistic concepts rather than weakening them.
1King, R. (2016). ‘Paying Attention’ in a Digital Economy: Reflections on the Role of Analysis and Judgement Within Contemporary Discourses of Mindfulness and Comparisons with Classical Buddhist Accounts of Sati. In Handbook of Mindfulness (pp. 27-45). Springer, Cham.
A leading TV show suggests Australian scientists may be close to a cure for different forms of dementia!
Australian documentary suggests a cure for dementia may be close
It was my impression that a cure for dementia was some distance away. Dementia is a complex syndrome that encompasses a number of different illnesses that appear to have both lifestyle and genetic causes. But today my attention was drawn to an episode of 60 minutes, an award winning TV show broadcast on Australia’s Nine network.
Personally I am skeptical of any potential ‘silver bullet’ cure for Alzheimer’s dementia, vascular dementia and different forms of early onset dementia. There is every chance that each of these diverse illnesses has a number of different contributory factors. However when I was told to about the 60 minute video I was happy to watch it with an open mind. Essentially an Australian scientist has been carrying out research in a small town in Colombia where the residents have a 50% probability of developing early onset dementia, leading to premature death before the age of 50. In identifying a genetic cause for the early onset dementia the researchers felt sure it would open the door to a cure for both vascular and Alzheimer’s dementia within five years. The show was broadcast in 2017 so if the work had progressed I would have expected to see more interest in the project by now. A quick search through the internet failed to find significantly more details than were contained in the actual TV show.
Feel free to take a look at the clip and if anyone out there uncovers more information about this project I’d welcome an email with some details. There is a fine line to tread between sensationalist claims and promising scientific research. I’m not yet sure which category this TV show falls into, take a look and make up your own minds.
Several features in the media this week have giving some clear indications about the science behind keeping our brains in the best possible shape. Some of the advice falls into the generic wellbeing wisdom which now seems to be be associated with most health messages;
eat more fresh fruit and vegetables, consume less processed meat
take regular exercise
give up smoking
stay socially engaged
avoid stress, relax and sleep the right amount
keep the brain working with appropriate activity and brain training
The last item on this wish list is unsettlingly vague given that it probably has the most significant impact on brain health. For example how can we define brain training (as almost everything we do can train the brain)? What is an appropriate level of activity and which parts of the brain should we focus on?
“In one study the brains of regular meditators were found to be years younger than non meditators”
In today’s Guardian, attention was drawn to a key finding of the MacArthur Studies of Successful Aging; that typically lifestyle and environment are more influential in our quality and length of life than genetic factors. This is also the general direction that brain science seems to be moving in with regards neurodegeneration. That although there are many questions left to be answered, limiting cognitive decline and reducing the risk of dementia may rest largely in our own hands.
Returning to the question of brain training, the big issue is to establish what kinds of intervention bring the greatest overall benefit? It is becoming increasingly apparent that narrow single task training such as Sudoku or word searches have a limited effect. Whereas maintaining high levels of brain activity and cognitive challenge are likely to keep a much broader area of the cortex young and healthy. The same principle needs to be applied if meditation systems are being used to maintain cognitive function. That the meditation or mindfulness method should be broad based and able to tap into both the intrinsic (internal) and extrinsic (task or external) networks. Activity in and between different neural networks is a key element in brain health and one frequently overlooked and poorly understood. To illustrate consider tonglen meditation, it combines compassion, nondual awareness and mindfulness, it allows the meditator to work with our internal visualisation and empathy systems. In addition it engages the important connectivity between introspection and external awareness.
Given what we know already about neurodegeneration, it seems likely that long term protection against cognitive impairment can be found in meditation methods built on nondual compassionate approaches.
No simple answers to dementia prevention but some clear signposts are starting to emerge.
How to protect your brain from dementia
This is not a simple question and there isn’t just one answer. Dementia is a term used to describe symptoms from a number of different illnesses, so different forms of dementia may require alternative approaches. However an article about how Jessica Langbaum keeps her brain young makes some points that we all can learn from. Jessica is the Associate Director of the Alzheimer’s Prevention Initiative at the Banner Alzheimer’s Institute in Phoenix, so she knows a thing or two about reducing the risk of developing dementia.
There is an enduring belief that activities such as Sudoku or app based brain training can offer some benefit is the battle against neurodegeneration. But Dr Langbaum makes the point that any exercise as narrow in scope as single task brain training is probably too limited to be of significant benefit. So that while Soduko for example, might help to keep the parts of the brain linked to simple calculations in good working order, this may offer little protection against Alzheimer’s dementia. The presumption is that maintaining large areas of brain function at high levels of performance is likely to keep overall brain health for longer. This idea is often described at the use it or lose it hypothesis, that once we start to scale down the demands on our brain we may unwittingly increase the risks of permanently losing function and structure.
“regular meditators have been observed to have both younger brains and thicker cortex than non-meditators”
The use it or lose it approach isn’t an ultimate answer but it does give us some great signposts about how to maintain brain health. I have often considered that continued use of meditation into middle and old age by Buddhists may be directly linked to the anecdotal evidence suggesting lower rates of dementia in certain groups of meditators. Many long term Buddhists increase their meditation practice in retirement and can frequently be found working for a range of good causes in voluntary and paid capacities, even at advanced ages. There is research that suggests spiritual practice per se might have a preservative effect on cognitive function but I think we must also consider the more direct influence of meditation methods on the regular renewal of brain function and structure.
Many well established Buddhist meditation practices such as tonglen have been designed as mind training systems. Their original goal was almost certainly not to reduce the risks of dementia, but they have long been associated with increasing wisdom, clarity and compassion. From the neuroscience point of view this means the methods are linked to activity in several of the most important brain networks, such as those connected to empathy, memory, attention, visualization and planning. This is specifically why Brain Renewal Meditation (BRM) has been developed with reference to reliable traditional methods and is also supported with research from neuroimaging and cognitive psychology.
The best advice we can offer to reduce your risks of developing dementia is to,
start early, cognitive decline begins in our late 20s
keep your brain as active as possible for as long as possible
stay socially engaged
stay physically active
watch your diet
try forms of brain training able to keep a range of brain structures firing
Photo of girl on swing by Artem Bali on Pexels.com, photo of Buddha statue by Oleksandr Pidvalnyi on Pexels.com
Why do people meditate? You might be surprised by the answer.
Want to know why people meditate?
Having introduced hundreds of people to meditation over the last fifteen years, the question of why do people meditate has always fascinated me. When I used to teach traditional Buddhist meditation many people would declare an interest in Buddhism or spirituality, but there was generally another reason that encouraged them to come to a class. Many came because they wanted some support with a health problem, either mental or physical and they thought that Buddhist meditation could offer them something. People attended classes to accompany their friends or because they were suffering a sense of loss, or were looking for direction in their life. But only a small minority meditated because they wanted to become a Buddhist or for some kind of spiritual development.
So interested was I in this question that I undertook some research while at the university, running a project asking people about their reasons for starting meditation. Health and wellbeing proved to be the single most popular answer both for traditional practitioners and secular mindfulness students, accounting for 55% of respondents. Although it now appears widely accepted that meditation can reduce stress and anxiety, and lead to increased levels of self reported happiness how this is achieved is still somewhat obscured. In particular if meditation has a lasting effect on behaviour then it must have a role in maintaining/changing brain structure and function.
“regular meditators with younger brains than non meditators”
This is the new frontier for contemporary meditation research, how does meditation change the brain and what are the likely effects of it? Evidence is suggestive that meditation can make a positive impact on your overall brain health and in one study regular meditators had brains seven years younger than non-meditators. The point is that meditation’s real potential is in changing brain structure, this is particularly relevant when talking about, the ageing brain, mild cognitive impairment and neurodegeneration. We are starting to see the first wave of meditation methods specifically designed to allow people to improve brain health generally. Given the pessimistic predictions surrounding dementia this seems like a trend set to continue.
Meditation for seniors. Meditation supports a healthy brain at any age.
Meditation for seniors; boost your own brain
Brain Renewal Meditation (BRM) is a simple system developed by meditation expert and trained neuroscientist Stephen Gene Morris. It offers methods designed to improve brain health and slow down the rate of cognitive (brain) decline. Aspects of our brain function such as memory and attention begin to deteriorate in our late 20s, however most of us don’t start to notice any changes until we reach our 40s. The point of BRM is that there are a number of things we can do to slow or perhaps even reverse aspects of cognitive decline at any point in our lives, even at 60, 70 or 80. If you have the capacity to concentrate there is a good chance that you can make a positive impact on your brain’s function and structure.
Meditation is probably the single most useful thing a person can do to help maintain brain health. There are hundreds of scientific studies that show an effect on cognitive performance linked to regular meditation. A key point to make is that different forms of meditation lead to different effects. BRM draws together elements of compassion, nondual and mindfulness meditation into one integrated practice. It is a secular practice which requires no previous experience of meditation, it can be undertaken sitting in any chair that allows you to keep your back straight. It can be practiced in a traditional meditation class or through online training in your own home.
Almost all of the evidence from neuroscience, psychology and traditional meditation systems points to our ability to improve our own brain function throughout our lives. For example a major strategic review of research into strategy-based cognitive training in older adults, strongly indicated than brain function can be enhanced even in middle and old age. The crucial point is that no mater what your age your brain remains plastic and can adapt to the demands of brain training in many forms, particularly meditation.
Follow this link for more information about BRM and how you can join a class.