Mindfulness Meditation in Autoinflammatory Diseases

Dr. Ezra Cohen, from Boston Medical Center and Boston Children’s Hospital, provides an introduction to mindfulness meditation in autoinflammatory diseases and discusses how it can be used by patients and their families.

This talk was presented as part of the “Managing your Autoinflammatory Disease: Lifestyle and Wellness Workshop,” which took place on April 28, 2018, at Boston Children’s Hospital in Waltham, MA. 

Stay tuned for more presentations from this autoinflammatory disease workshop over the next few days! 

The transcript has been edited for clarity.

Dr. Ezra Cohen: Welcome all. I trained in rheumatology and did a lot of research in complementary therapies and have done a lot of exploration in mindfulness over the years and have personally benefited a lot, so I thought I would spend a few minutes and introduce it to you. I’m sure people have heard of mindful meditation—It’s permeated our culture pretty deeply—but I’d like to just describe at least what I perceive it to be and in what ways it could be beneficial for kids and for families.

Mindfulness is a secular term ultimately derived from meditative practices, in particular in Buddhism, and Hinduism. Over the last 30 or 40 years, it’s been increasingly incorporated into the medical community, has acquired more legitimacy and there’s been an enormous amount of research that been done on it. I think it’s also becoming a regular part of psychological practice and psychologists have become a bit savvier than probably most physicians by this point.

The overall simplest definition is the attempt to cultivate a stable nonreactive awareness of what’s going on in your mind. Stable, nonjudgmental awareness. I think that is something that is very counter to our usual thought processes, which flip back and forth between lots of different things. I think from an evolutionary perspective, it was most beneficial to be able to make very quick judgments about things. I also think that anxiety and worry probably had evolutionary benefits because it allowed survival of those that moved the quickest when there was a threat nearby.

We’re stuck with primitive brains in a contemporary world. Mindfulness is an attempt to slowly adapt your mind to living in the modern world.

I also have a couple of things that I’ve written over the years and some things to think about. There are many, many different ways to practice meditation. It depends on the age of the child, but the most basic exercise is, with the eyes open or closed, to focus on your breathing. Some people find counting helpful initially. Picture the breath going in and out.

I think a lot of people have the perception that the idea of meditation is to think of nothing. I think realistically, what ends up happening, is this continuous dance where thoughts come in, you notice them and get carried away for five minutes before you realize you’re carried away, and then you come back. The hope is that either over the course of the session or over a lifetime of practicing, those diversions come a little less frequently.

The analogy that I’ve read and used, as you’re focusing on your breathing, it’s like a horse being led through an orchard or along a path, passing by the trees. The horse is constantly looking to take a bite and the horse is your mind. The idea is to pull the reins not too tight, not too loose. If you pull the reins too tight, the horse will buck you off. That occurs if you’re too critical or you’re trying to be too controlling of what’s going on in your mind and your thoughts. If you’re too loose, you’re not really disciplined enough, and the horse gets carried away also into the orchard and off into a different pathway.

A lot of people ask whether it’s a religious practice, but it has become very much a secular thing. It’s been studied in a very secular way, so it does not need to relate to religion at all, but it has certain similarities to prayer for those who subscribe to religion. There are a lot of benefits that have been studied but I think that things that are the most immediate and obvious are that it has a really dramatic impact on anxiety and worry and coping with pain when practiced regularly.

I think ultimately, and I can say this from personal experience, it really can extend beyond just a specific problem-based approach and can affect your philosophy and, when practiced regularly, give you more of an appreciation for slowness, and enjoyment of change, and appreciation of the beauty around you, and all those things that we all strive for.

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