The Congregation at Duke University Chapel

PEACE WITHIN: Meditation and Mental Health


PEACE WITHIN: Meditation and Mental Health

-- Theresa A. Yuschok, M.D.
Congregation at Duke Chapel Adult Forum
April 1, 2012

Common Psychiatric Responses to Disaster

Ursano, et al, Psychiatric Dimensions of Disaster, Harvard Review of Psychiatry, Nov/Dec 1995

  • Acute Stress Disorder –w/in 4 weeks
  • PTSD
  • Substance Abuse
  • Major Depression
  • Generalized Anxiety
  • Psychological Factors Affecting Physical Disease
  • Bereavement
  • Angry Outbursts/ Family Violence

Stress Mediators:


  • Developmental Hx
  • Biological Factors
  • Pre-existing Illness
  • Previous Trauma
  • New Trauma/Disaster
    • Threat to life
    • Physical injury/harm
    • Loss of loved one
    • Intentional harm

vs. Resilience

  • Social Supports
  • Socio-cultural Context
  • Meaning
  • Appraisal
  • Attribution
  • Stress Mgmt Skills

Spiritual Self-care

National Center for PTSD,

  • Nature
  • Community
  • Values
  • Purpose and Meaning
  • Music and Worship
  • Reflection
  • Meditation and Prayer

The Peace of Wild Things

by Wendell Berry

When despair for the world grows in me
and I wake in the night at the least sound
in fear of what my life and my children’s lives may be,
I go and lie down where the wood drake
rests in his beauty on the water, and the great heron feed.
I come into the peace of wild things
who do not tax their lives with forethought
of grief.  I come into the presence of the still water.
And I feel above me the day blind stars
waiting with their light.  For a time
I rest in the grace of the world, and am free.

Stress Response

--Hans Selye, The Stress of Life


target on my head


Stress deregulates the endocrine system

  • SNS→Epinephrine & NE (2-3 sec)
  • P. Hypothalamus→ad.medulla→E/NE (30sec)
  • CRH→ACTH→Cortisol and aldosterone (days)
  • Vasopressin (ADH)→increases BP
  • Decrease Prolactin (chronic)
  • Decrease Growth Hormone (chronic)
  • Increase endogenous opiates
  • TRH→TTH→inc thyroxine & tri-idothyronine
    • Thyroxine→ of heart, GI, brain

Stress & Immunosuppression

Lymphocytes and macrophages have Epi/NE receptors, and E/NE inhibit T-cell proliferation and decrease IL-2 receptors and production

Inc. CRF→ACTH→adrenocorticosteroids

  • Cortisol:
    • Mobilize free FA, proteins, aa, glucose, vitamins
    • Initiate gluconeogenesis, decrease body wt, promote muscle wasting, decrease insulin production, increase BP
    • Break down antibodies, impair immune system, B-cell depletion

Fight-Flight-Freeze Response:

Sympathetic Nervous System Excess

  • Increased blood pressure, pulse(CAD)
  • Increased EMG response (pain)
  • Disturbances in glucose metabolism (DM)
  • Inc Respirations/ dilate bronchioles
  • Dilate pupils
  • Piloerection
  • Ejaculation
  • Decrease intestinal secretions/salivation

Parasympathic Nervous System

maintains homeostasis, conserves energy

  • Decrease HR, BP, R
  • Cell growth
  • Digestion/ Increase salivation
  • Relaxation and Sleep
  • Collect wastes
  • Erection
  • Pupils constricted

Relaxation Response

by Herbert Benson

on top of the world
  • Quiet environment
  • Comfortable position
  • Focus on your breath or a meaningful word or phrase
  • Passive attitude—being not doing


by David Whyte, The Heart Aroused

These few words are enough
If not these words, this breath.
If not this breath, this sitting here,
This opening to the life
We have refused
Again and again
until now.
Until now.

Meditation and EEG

  • Beta brain waves (14-50 cycles per second)
    • Logical, rational, worried, alert
  • Alpha brain waves (8-13 cps)
    • Peaceful, floating, pleasant, relaxed
  • Theta brain waves (4-7 cps)
    • Deeply relaxed, in reverie
  • Delta brain waves (3 or less cps)
    • Sleep

Perceptional Changes during Meditation

  • Time Distortion
  • Ineffable—no words for the experience
  • Present-centeredness—now
  • Perceptual distortions--synethesias
  • Enhanced receptivity
  • Self-transcendence

Meditation accesses the right brain functions:


  • Analytical
  • Judgmental
  • Time consciousness
  • Verbal Acuity
  • Linear thought
  • Rational
  • Math


  • Synthesis
  • Receptive
  • Timelessness
  • Imagery/Imagination
  • Non-linear
  • Intuition
  • Humor
  • Spatial Organization

Meditation and Brain Pathways

d’Aquili, EG & Newberg AB (1993a) Religious and Mystical States: A Neuropsychological Substrate, Zygon, 28: 177-200.

  • Increase Posterior Frontal Cortex activity
  • Deafferentation (blocking) of PSPL
  • Dec. Posterior Superior Parietal Lobe activity
  • Activate the “Holistic Operator” Rt PSPL along with left cerebral hemisphere function
  • Limbic system (amygdala, hippocampus, hypothalamus) assigns emotions of bliss.
  • AUB= absolute unitary being

Meditation and Hormones

  • Decrease cortisol
  • Decrease aldosterone
  • Increase melatonin
  • Increase growth hormone?
  • Increase prolactin?

Meditation Immunoenhancement

  • Decrease cortisol
  • Decrease infections, allergies
  • Increase in NK (Natural Killer) Cells
  • Emotional thought influences structural changes in neuropeptides (Candace Pert) which communicate between brain and T-cells and B-cells.
  • Increase IgA in Saliva

Health Benefits of Meditation

  • Decrease resting HR, BP, R
  • Decrease cholesterol and atherosclerosis
  • Enhance Immune System
  • Manage Pain
  • Decrease nausea/vomiting
  • Increase Longevity?

NH study x 3 years, 0 deaths in those meditating, and 40% mortality in controls

Alexander CN, et al. 1989 TM, Mindfulness and Longevity: an experimental study with the elderly, J. Pers. Soc. Psychology 57:950-964. 1989


Psychological Benefits of TM

  • Increase creativity
  • Increase productivity
  • Reduce anxiety
  • Reduce drug use and eliminate drug abuse
  • Decrease crime and violence

Types of Meditation

Exclusive         vs

  • TM/ Mantra/RR
  • Visual Concentration
    • Gazing or tratak
  • Repeated sounds
    • Chanting or nadam
  • Physical repetition
    • Walking, whirling
  • Tactile repetition
    • Mala or rosary


  • Zen/zazen
  • Mindfulness
  • Medical Mindfulness
  • Metta/ Lovingkindness
  • Contemplation

DBT Core Mindfulness Skills: WISE MIND

  • Emotional experience
  • Reasonable mind
  • Intuitive knowing

DBT Core Mindfulness Skills:

What         &









Observe feelings, experiences, sensations, thoughts,impulse. Let it be.

Describe the experience in words.

Free association?

Be in the moment, engrossed, intuitively acting.

RUMI: Out beyond ideas of wrong-doing or right-doing there’s a field. I’ll meet you there

Acknowledge and accept. Don’t judge judging.

Focus on one thing at a time. Let go of distractions. Monkey mind.

Don’t cut off your nose to spite your face. Keep your eye on the ball.

Let go of revenge and indignation


12 Steps of Alcoholics Anonymous

  1. Powerless
  2. Believe a Higher Power can help.
  3. Submit our will
  4. Moral inventory
  5. Admit our wrongs
  6. Ready to have God remove defects.
  7. Ask for healing
  8. List of those harmed
  9. Make amends
  10. Moral inventory
  12. Practice and share spiritual awakening

  • 15 million attend over 500 assemblies per week.
  • AA,started in 1935, and was the only self-help group until 1970.
  • Now there’s NA, Gamblers A, Alateen, Sex Addicts A, OA, Debtor’s A, ....
  • All are based on these 12 steps. Note # 11.
  • To study this, there have been over 15 questionnaire surveys of long-term AA members
    • 40-50% of alcoholics who join AA become long term members,
    • 60-68% adults and 75% teenagers remain abstinent.
  • This will not put MH out of business, because 50-60% drop out within 90 days.
  • Only 25% drop out if they are also in professional therapy.

In 1999 a Survey testing the Brown-Peterson Recovery Progress Inventory, showed 100% of successfully recovered uses prayer and 100% spiritual practice such as QT / meditation. 91% regularly reading spiritual literature or personal inspiration.

This has been criticized for external locus of control undermining confidence in changing one’s life. Advocates for a secular approach say a spiritual path is not necessary and offer alternatives such as Rational Recovery 1985, Save Our Selves, Secular Organization for Sobriety, and WFS (Women for Sobriety).

Others criticize that AA is not Religious enough and have started Christian groups called Teen Challenge or Alcoholics for Christ.

In 1997 Project Match compared Motivational Enhancement Therapy, 12-step Facilitation, and CBT, to propose that the match between the addict and the program is what matters



  • Praise and Thanksgiving
  • Confession
  • Lamentation
  • Intercessory
  • Petition
  • Communion
  • Contemplative (Silence)

Maslow’s Hierarchy of Needs

  1. Physiological needs
  2. Safety needs
  3. Belonging and Love
  4. Need for Self-esteem
  5. Self-actualization
  6. Self-transcendence


dancing with the stars
Peace. It does not mean
   to be in a place where
   there is no noise,
   trouble, or hard work.
It means to be in the
    midst of those things
    and still be
    calm in your heart.  

Internet Resources
508 research studies of the value of TM
Templeton foundation supports research on forgiveness, optimism, spirituality, and health.
Psychology and Spirituality Institute, essays