Stray thoughts on centering prayer, a JAMA study on mindfulness meditation and a way to stop ‘catastrophizing’

This Associated Press story jumped off the Yahoo! directory at me. Uh, let’s rephrase that in the interest of accuracy — it jumped off the computer screen. It’s headlined “Mindfulness worked as well for anxiety as drug in study,” and it’s essentially a rewrite of research published today in the medical journal JAMA Psychiatry. It seems to fit right in with centering prayer, another spiritual practice I’m relying on to get me through chemo, and I’m archiving it here so I know where to come back to it and study it as needed.

A little background: Last month I had a tumor removed from my bladder. It was malignant, and I’m in the process now of getting scheduled for chemotherapy. Let’s just say it gives me plenty to think about.

Written by AP science writer Lindsey Tanner, the story caught me attention because it features something I’ve discovered in centering prayer, a Zen-like practice that includes (among other valuable things) a technique for dealing with anxiety. Or, in my case, dealing with random thoughts that swiftly morph into worst-case scenarios. A speciality of mine!

Says Tanner, quoting from an interview with the the study’s lead author:

Instead of ruminating over the troubling thought, “you say, ‘I’m having this thought, let that go for now,’’’ said lead author Elizabeth Hoge, director of Georgetown University’s Anxiety Disorders Research Program. With practice, “It changes the relationship people have with their own thoughts when not meditating.”

This is almost exactly like something Fr. Thomas Keating and other practitioners of centering prayer recommend. When bad thoughts intrude — oh, like wondering what chemo’s going to be like, for example — you gently take notice of them and repeat a “prayer word” instead. It might be something like shalom or the name of Jesus. Mine is “trust,” because that’s what I’m especially needing at the moment. Trust in the process. Trust in my doctors. Trust, even, in the idea that centering prayer might do me some good.

And as you repeat the word, you let the thought go.

Let it go, and poof, it’s gone. At least in the moment. Does any of this sound familiar? The middle steps of 12-step recovery work very much the same way: Name it in the fourth and fifth steps, turn it over in the sixth and let go in the seventh.

And here’s the good part: It seems to work. I blogged about it HERE and HERE before I got my diagnosis, and I’ve been relying on the technique — thought, prayer word, poof, it’s gone — even more, now that I have.

More recently, I’ve taken my prayer word — “trust” — and expanded it a little. First to “trust in the Lord,” and then (after a Google keyword search) to this passage from the Hebrew Bible (Proverbs 3:5-6 in the NRSVUE):

Trust in the Lord with all your heart,
    and do not rely on your own insight.
⁶ In all your ways acknowledge him,
    and he will make straight your paths.

If nothing else, it’s a way of heading my worst-case scenarios off at the pass.

So here’s a secular psychological study, at Georgetown no less, that goes into the same thing. And corroborates it, as far as I’m concerned. For quite a while it has been known that meditation can help reduce the stress associated with diseases ranging from hypertension and chronic pain to irritable bowel syndrome. This study focused on the effects of meditation, comparing them to a drug used to treat anxiety disorders. Tanner’s lede gives the who-what-when-when:

Mindfulness meditation worked as well as a standard drug for treating anxiety in the first head-to-head comparison.

The study tested a widely used mindfulness program that includes 2 1/2 hours of classes weekly and 45 minutes of daily practice at home. Participants were randomly assigned to the program or daily use of a generic drug sold under the brand name Lexapro for depression and anxiety.

After two months, anxiety as measured on a severity scale declined by about 30% in both groups and continued to decrease during the following four months.

Some more detail, further down in the story, gives it a bit of scientific rigor:

The results were based on about 200 adults who completed the six-month study at medical centers in Washington, Boston and New York. Researchers used a psychiatric scale of 1 to 7, with the top number reflecting severe anxiety. The average score was about 4.5 for participants before starting treatment. It dropped to about 3 after two months, then dipped slightly in both groups at three months and six months. Hoge said the change was clinically meaningful, resulting in noticeable improvement in symptoms.

Ten patients on the drug dropped out because of troublesome side effects possibly related to treatment, which included insomnia, nausea and fatigue. There were no dropouts for that reason in the mindfulness group, although 13 patients reported increased anxiety.

I wasn’t familiar with Tanner’s reporting before (I’m a news junkie, but my drug-of-choice is politics and government), but she covered the bases I expect in a good science writer. (Back in Tennessee I covered a Department of Energy think tank, a sister facility to Fermilab, and, oh, man, I could tell you stories about what the out-of-town media got wrong.) For one thing, Tanner goes beyond the four corners of the JAMA study to interview other scientists, who generally agreed with its findings. She even interviewed a participant in similar research that lead author Elizabeth Hoge conducted earlier. Said Tanner:

Olga Cannistraro, a freelance writer in Keene, New Hampshire, participated in an earlier mindfulness study led by Hoge and says it taught her “to intervene in my own state of mind.’’

During a session, just acknowledging that she was feeling tension anywhere in her body helped calm her, she said.

Cannistraro, 52, has generalized anxiety disorder and has never taken medication for it. She was a single mom working in sales during that earlier study — circumstances that made life particularly stressful, she said. She has since married, switched jobs, and feels less anxious though still uses mindfulness techniques.

Here’s how I think it works: Acknowledge the anxiety, make note of it — with or without a prayer word — and let go.

Now there’s a better word for it! From a quote in a writeup by public affairs officer Sue McGreevey of Massachusetts General Hospital of a related study at Mass General (a Harvard affiliate), in the Harvard Gazette, a publication of the university’s public relations office:

Co-senior author John Denninger of the Benson-Henry Institute at MGH noted, “One interesting clinical impact was a decrease in both IBS [irrritible bowel syndrome] and IBD [inflammatory bowel disease] patients in what is called pain catastrophizing — a negative cognitive and emotional response to pain or the anticipation of pain. In other words, participants became more resilient in the face of the pain they were experiencing. But before we can offer a program like this to patients with these disorders, we’ll need to conduct a longer, randomized trial with a control group and enough participants for statistically significant results.”

“Catastrophizing!” That’s exactly what I do when I’m feeling anxious and I’m left to rely on my own insights.

Citations

Lindsay Tanner, “Mindfulness worked as well for anxiety as drug in study,” Associated Press, Nov. 9, 2022 https://news.yahoo.com/mindfulness-worked-well-anxiety-drug-162719117.html.

Also:

Jeffrey M. Greeson and Gabrielle R. Chin, “Mindfulness and Physical Disease: A Concise Review,” Current Opinion in Psychology, 28 (August 2019), 204-210 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6597336/.

Elizabeth A. Hoge, MD¹; Eric Bui, MD, PhD²; Mihriye Mete, PhD³; et al, “Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety DisordersA Randomized Clinical Trial,” JAMA Psychiatry, Nov. 9, 2022 https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2798510.

Sue McGreevey, “Meditation may relieve IBS and IBD,” Harvard Gazette, May 5, 2015 https://news.harvard.edu/gazette/story/2015/05/meditation-may-relieve-ibs-and-ibd/.

[Revised and uplinked Nov. 10, 2022]