Month: November 2020

Pregnancy, childbirth and the first weeks of parenthood are times of change, challenge and, for some, anxiety. This is especially so for those prone to worry or prone to low mood.  It can also be an anxious time for those who have previously experienced a stressful childbirth… or even a stillbirth or miscarriage; while those suffering from “health anxiety”, may find the whole journey extremely challenging.

Further, it is common for those who have previously experienced difficult births to demonstrate symptoms of PTSD.  While after the birth, the pressures on a new parent may cause “post-natal depression” or anxieties about the health of the infant.

It’s quite a list of potential problems.  In response I have been thinking about how Mindfulness Based Cognitive Therapy (MBCT) can help prepare and support women (and their partners) through pregnancy, childbirth and early parenthood.

The good news is that there is solid research to show that for pregnant women MBCT can:

• significantly reduce anxiety
• significantly reduce depression
• increase self-compassion – to avoid negativity and remain positive about their capability as a mother
• and, reduce postnatal depression and anxiety.

Here is a 2014 paper from Boston, published in “Women’s Mental Health”, that monitored the impact of an MBCT  programme on expectant mothers who were assessed as “clinically anxious” by week 27 of their pregnancy or earlier. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4107206/

The research shows that MBCT was very effective:

“Completers showed statistically and clinically significant improvements in anxiety, worry, and depression, and significant increases in self-compassion and mindfulness. Of the 17 participants who met GAD criteria at baseline, only one continued to meet criteria post-intervention. Participants regarded their experience in the intervention to be overwhelmingly positive.

I would add that It is important to know that, in other trials, MBCT is shown to reduce worry – even for those who are not anxious – i.e. it is not a treatment that just helps those who are anxious – it reduces the level of worry in all participants.

 

Here is a further 2016 paper from University of Colorado that describes a randomised controlled trial to  demonstrate how MBCT can significantly reduce both the possibility and impact of postnatal depression… even within mothers who had suffered similar problems in the past.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718345/

“At-risk women randomly assigned to MBCT reported significantly improved depressive outcomes compared to participants receiving treatment as usual, including significantly lower rates of depressive relapse/recurrence and lower depressive symptom severity during the course of the study.”

I reflect that while there is a lot of research to show the positive impact of MBCT for expectant mothers who previously experienced stillbirths there was no research to show how it could help mothers who had previously experienced difficult or traumatic births – this may be down to the difficulty of identifying or categorising such subjects,  but I wondered if there might still be a blindspot so that hospitals are not realistic about the damage that such experiences can cause.  Most of us have friends or relatives who have been traumatised by a birthing experience.

At Carina Sciences we believe that these trials, together with other encouraging studies, suggest that MBCT can address PTSD symptoms, anxiety and depression associated with pregnancy, childbirth and the postnatal period.  We are looking at how we can provide specific material for pregnant women and their partners.  Meanwhile, if someone you know would benefit  from trying our Rezl app then please get in touch with us.

As part of the eight step Mindfulness Based Cognitive Therapy (MBCT) programme within our Rezl app, we include a session on compassion and self-compassion – and the practice of a “loving kindness’” mediation… where one shows compassion to oneself:

“May I be happy. May I be healthy. May I live with ease of mind.”

and then show compassion to others – even those who you may not initially feel kindly towards:

“May you be happy. May you be healthy. May you live with peace of mind.”

Most secular mindfulness training programmes include such a topic within their content.

The excellent book “Altered Traits: Science Reveals How Meditation Changes Your Mind, Brain, and Body” by Daniel Goleman  and Richard J. Davidson  touches on how scientific methods (bio markers and brain scans) were used to monitor the impact of such meditations. The book suggests that there are “levels of compassion” that may be experienced (my words not theirs). Off the top of my head,  I recall that if you see someone “suffering” then there are three “levels of compassion”: 1. that you can intellectually understand that someone is suffering; 2. that you can related to how they are feeling; and 3. that you suffer in response to their suffering (i.e. you may be distressed by their distress).  This last may be the precursor to your own intervention in a situation.

The training of our own ability to show self-compassion is very important if we are to avoid negative thinking and social anxiety… including “imposter syndrome” or feeling or low self-esteem etc; while ability to show compassion to others should make us “better citizens” shouldn’t it?

This last idea is the subject of a paper I noticed recently. “Does Mindfulness Training Without Explicit Ethics-Based Instruction Promote Prosocial Behaviors? A Meta-Analysis”  by Daniel R. Berry of California State University San Marcos published in Personality and Social Psychology Bulletin January 2020. https://journals.sagepub.com/doi/10.1177/0146167219900418

The paper is a meta-analysis, looking at randomised controlled trials involving “secular mindfulness” that excluded ethics-based concepts (i.e. guide on right or wrong). The aim was to investigate if these mindfulness interventions caused subjects to be more “prosocial” (– more compassionate, less prejudiced and less likely to retaliate) despite the lack of ethics-based content.

The good news was that the research showed that: “Reliable effect size estimates were found for single-session interventions that measured prosocial behaviour immediately after training. Mindfulness training also reliably promotes compassionate (but not instrumental or generous) helping and reliably reduces prejudice and retaliation”

So besides the resilience, mental well-being boost, and performance advantages (e.g. to focus and  to remain objective under pressure) – it turns out that Mindfulness may just help to make us nicer people!