BackgroundAmong underserved, largely minority women who were breast cancer survivors, this pilot project was designed to evaluate the quality of life outcomes of a 20 week Contemplative Self-Healing Program.MethodsWomen previously treated for stage I-III breast cancer were assessed before and after the 20 week program with the FACT-G, FACT-B, FACIT-Spirituality, ECOG, and the Impact of Events Scale. They participated in a 20-week intervention involving guided meditation and cognitive-affective-behavioral learning.ResultsWith an average age of 63, 62% of the participants were African-American or Latino. With an average of 5.4 years since the diagnosis of breast cancer, 72% had an ECOG performance status of 1. 57% were currently working.Their baseline FACT-G was 80.5 ± 15.1, and their baseline Impact of Events Scale was 26.3 ± 18.9. The within-patient improvement on the FACT-G was 4.6 ± 10.9 (p = .01); in parallel the FACT-B improved by 2.8 ± 12.8 points (p = .03). The Impact of Events Scale improved by 6.6 ± 15.5 points (p = .01). There was significant within-patient improvement on both the avoidance scale (3.8 ± 9.2) and on the intrusion scale (2.9 ± 7.9). Patients who attended more sessions and conducted more home practice had greater improvements in quality of life.ConclusionPersons receiving a 20-session contemplative self healing intervention showed improved quality of life, with a clinically and statistically significant increase in the FACT-G. In addition, this population showed a significant reduction in post-traumatic stress symptoms assessed by the Impact of Events Scale.Trial registrationClinical Trials Gov NCT00278837.

Along with symptoms of anxiety and depression, many breast cancer survivors experience symptoms of posttraumatic stress disorder (PTSD) that may worsen in the setting of other stressful life events. The aim of this pilot study was to evaluate whether a 4-week version of our Contemplative Self-Healing program would have different effects in reducing PTSD symptoms between breast cancer survivors with or without chronic stress at baseline. PTSD symptoms were measured using the Impact of Events scale (IES). A linear mixed model analysis was used to evaluate within patients changes in IES score. Results showed that breast cancer patients who were experiencing chronic stress reported greater improvement in IES score than those without chronic stress. Our preliminary findings shed light on the need to evaluate life stressors in breast cancer patients. Evaluating chronic stress may be essential in predicting which cancer patients may benefit most from a psychological intervention.

This overview surveys the new optimism about the aging mind/brain, focusing on the potential for self-regulation practices to advance research in stress-protection and optimal health. It reviews recent findings and offers a research framework. The review links the age-related biology of stress and regeneration to the variability of mind/brain function found under a range of conditions from trauma to enrichment. The framework maps this variation along a biphasic continuum from atrophic dysfunction to peak performance. It adopts the concept of allostatic load as a measure of the wear-and-tear caused by stress, and environmental enrichment as a measure of the use-dependent enhancement caused by positive reinforcement. It frames the dissociation, aversive affect and stereotyped reactions linked with stress as cognitive, affective and behavioral forms of allostatic drag; and the association, positive affect, and creative responses in enrichment as forms of allostatic lift. It views the human mind/brain as a heterarchy of higher intelligence systems that shift between a conservative, egocentric mode heightening self-preservation and memory and a generative, altruistic mode heightening self-correction and learning. Cultural practices like meditation and psychotherapy work by teaching the self-regulation of shifts from the conservative to the generative mode. This involves a systems shift from allostatic drag to allostatic lift, minimizing wear-and-tear and optimizing plasticity and learning. For cultural practices to speed research and application, a universal typology is needed. This framework includes a typology aligning current brain models of stress and learning with traditional Indo-Tibetan models of meditative stress-cessation and learning enrichment.