Research Engine

The Mindfulness Center opens at Brown

An interview with director Eric Loucks on how the new center combines rigorous research and methodology with mindfulness interventions to achieve significant health outcomes

Photo by Richard Asinof

Eric Loucks, the director of new The Mindfulness Center at Brown.

By Richard Asinof
Posted 9/18/17
The opening of The Mindfulness Center at the School of Public Health at Brown University is creating a hub of innovative research and training around mindfulness interventions, with the potential to achieve significant clinical health outcomes.
Will the Governor’s Task Force on Overdose Prevention and Intervention consider mindfulness techniques as a strategic approach? What are the opportunities for the behavioral and mental health practitioners to consider adopting the mindfulness interventions that have proven to be so successful in the United Kingdom? Will health insurers consider reimbursing patients for mindfulness training? Will businesses consider adopting mindfulness interventions as part of their health, wellness and prevention activities? Will the new provider directory being discussed as part of the State Innovation Model consider including mindfulness providers and practitioners?
There are many ways to nourish the development of the emerging innovation ecosystem in Rhode Island, beyond calculating job growth and job losses as an economic indicator. Whether it is in efforts to promote design as an intrinsic resource in Rhode Island, or to celebrate the diversity of Rhode Island’s population, the opening of The Mindfulness Center as a innovative research hub at Brown offers the potential to grow an entirely different kind of industry cluster. The use of wearable devices such as FitBits as part of the randomly controlled research trails points to a sophisticated use of data analysis, one that currently seems a unique application.

PROVIDENCE – The official opening on Sept. 13 of The Mindfulness Center at the School of Public Health at Brown University celebrated, in many ways, the endorsement by Brown of the distinctive approach being pursued by the new academic center, embracing its work as a hub for innovative and rigorous mindfulness research, training and teaching, focused on achieving better outcomes in health and wellness.

Under a $4.7 million grant in 2015 from the National Institutes for Health, a team led by Eric Loucks, the director of the Mindfulness Center and an associate professor of Epidemiology, has been researching the relationship between mindfulness and cardiovascular health, with impressive clinical results to date.

Brown, in turn, has endorsed mindfulness techniques for its staff as a way to reduce stress, offering sessions two to three times a semester. And a new pilot program, a mindfulness intervention for undergraduate students called “Mindfulness Based College,” a randomized research trial is now underway, employing FitBits to track certain kinds of health data.

In addition, working in collaboration with Lifespan, The Mindfulness Center is creating a biobank, where blood and tissue samples are being stored in freezers.

“In the future, if we have other ideas on potential mechanisms on how mindfulness could influence heart health, we just need to pull the vials out of the freezer and send them to the lab and get them assayed,” Loucks explained in an interview with ConvergenceRI.

There is a lot of interest, Loucks continued, “In how mindfulness may influence inflammatory markers in the blood, or lipids, or glucose regulation. When you have a biobank, it makes it much more cost effective to get the answers to those questions. We don’t have to run all those people through new mindfulness interventions.”

Loucks said that the team at The Mindfulness Center encourages a healthy skepticism about its work and its meditation techniques. “With mindfulness, we really encourage healthy skepticism,” he explained. “We encourage people to try it out for themselves, and if it works, that’s great, and if it doesn’t, that’s fine, too. Some of my best study participants are skeptical, because if they are skeptical and open to the experience, they can often have pretty big transformations.”

From a scientific perspective, Loucks continued, “That is why the center is providing the evidence and why it is committed to reporting whatever we find, doing the most methodologically research that we can. Because we want to find out what the truth is.”

The tag line for The Mindfulness Center is “research, methods, service.” As part of the mission of service, the center will be creating a new website, tentatively scheduled to launch in the next six weeks, creating a pipeline of reliable information that will enable people who want to learn more about mindfulness interventions to be able to access a provider directory.

As Loucks explained it, “We wanted to create a transparent, straightforward mechanism to list all of the mindfulness providers in the state that we are aware of, including the mindfulness interventions that are being offered, the evidence behind it, who the provider is, and their contact information, and the target patient population.”

Here is the ConvergenceRI interview with Eric Loucks, the director of The Mindfulness Center, describing in detail some of the innovative research now underway in Rhode Island using mindfulness interventions.

ConvergenceRI: How important was the full-throated endorsement of The Mindfulness Center by Brown Provost Richard Locke and School of Public Health Dean Terrie Fox Wetle at the Sept. 13 event, in terms of validation?
LOUCKS:
In the state of Rhode Island, we’ve had all these pieces of the puzzle getting formed, where we have a number of evidence-based models and interventions already happening – at Rhode Island Hospital or at Miriam Hospital, with mindfulness stress reduction, and in community settings.

And then we’ve got researchers, some of the top in the world at Brown, doing really important work on the impact of mindfulness on psychosis, on depression, on sleep, on hypertension, even on the potential adverse effects of meditation practices.

This new center is helping to put that all together. In many ways, it’s not so much about validation; it is the natural next steps, given what’s happening in the state right now.

ConvergenceRI: In your work under the 2015 NIH grant, the focus has been on using mindfulness interventions around heart disease and stroke, to reduce things such as stress, high blood pressure. What have been some of the clinical results to date, and how has the work changed the approaches in the medical community?
LOUCKS:
We have two programs in the works around heart disease that are in the field right now. One is a mindfulness-based blood pressure reduction study. That one is showing reductions of systolic blood pressure in the range of 14 millimeters of mercury after six months. Not only is it working quickly but it seems to have sustained effects through six months. We will be getting the one-year data in a couple of months.

One of the reasons why we’re really focused on evidence-based mindfulness practices is that we want to see what the findings are, with important clinical health outcomes and the mechanisms involved. That is starting to get the attention of clinicians for [the ability] to impact the determinants of heart disease.

We have also received funding to develop a mindfulness project rehabilitation program. We’re just in the early stages of that.

ConvergenceRI: What kinds of interventions with mindfulness are underway in the behavioral and mental health fields?
LOUCKS:
Two of our members are very strong in that regard. Brandon Gaudiano, [an associate professor of Psychiatry and Human Behavior], is using mindfulness informed interventions in what’s called acceptance and commitment therapy for people suffering from psychosis. His work has demonstrated marked reductions in rehospitalization rates in two cities, here in Providence and in Philadelphia.

Willoughby Britton, [the director of Brown’s Clinical and Affective Neuroscience Laboratory], is very focused on mental health, including depression and anxiety. She’s done a study where she took a standard mindfulness intervention, called mindfulness based cognitive therapy, or MBCT, and [broke] it apart into two different major elements: one is called focused attention meditation, where people really focus on one particular thing, and train the mind to be able to place [their thoughts] where they want to place it; the other is a very common meditation technique called open awareness, where people are monitoring their thoughts, emotions and physical sensations.

These are the two major forms of meditation that are practiced in the West. She was able to look at the impacts on [study participants’] sleep and their mental health and found some unique differences.

So, there is quite a bit of research being done by our center members on mental health outcomes.

ConvergenceRI: How open has the clinical community been to adopting these mindfulness techniques in Rhode Island for mental health and behavioral health interventions?
LOUCKS:
That’s a good question. Two of the major mindfulness interventions that exist that are being offered at local hospitals for mental health, one is dialectical behavior therapy, or DBT, the other one is acceptance and commitment therapy.

The one that Willoughby has been researching is pretty ubiquitous in the United Kingdom. And, the National Health Service funds it now for the entire population of the U.K., for anyone who has had at least three [episodes] of depression is eligible.

The [mindfulness] intervention has been reviewed and an analysis was published in JAMA Psychiatry last year, which put together all the studies and all the randomized control trials that evaluated this intervention, and they found that it was even outperforming antidepressants. It’s got very strong evidence.

UMass Worcester is offering it, and one of our colleagues teaches it up there, but it hasn’t made it into Rhode Island yet.

It is a real opportunity; it is very much an evidence-based practice that I think would help a lot of people. It is helping people around the world, but it hasn’t made it as much into the United States. But it is on its way.

ConvergenceRI: I was impressed that the provost has endorsed a mindfulness program for staff at Brown. How does that work?
LOUCKS
: He has been very supportive of mindfulness programming at Brown. Announcements about when sessions will be held go out in the morning mail to all the staff. We’ve been offering mindfulness sessions a couple times a term. Attendance has been very strong, with 30 to 40 people there for one-hour sessions. We’ve gotten really good feedback. We piloted it last year.

The other piece that we have developed is a mindfulness intervention for undergrad students, called “Mindfulness Based College.” We’re doing it as a randomized control trial.

The results have shown some remarkable things so far. One of the things that we’re seeing over the course of a term is that the students randomly assigned to be part of the wait list control group is that their depressive symptoms are going up significantly, their sleep duration is going down, and their alcohol consumption is going up.

For those in the “Mindfulness Based College” intervention group, it almost seems as if it is providing resilience for them in the face of the stressors at the end of the term, when exams are coming up and their term papers are due. What’s happening with them is that their depressive symptoms are staying stable, and their sleep is staying stable.

The students are all wearing FitBits.

ConvergenceRI: Have the students agreed to share their data?
LOUCKS:
Yes. We actually have a contract with FitBit, so we have a customized database for research purposes, so the data gets uploaded to the FitBit database.

ConvergenceRI: When is the data shared with the students?
LOUCKS:
As part of the class, we give them their health information on the first day of class; they get to see what their diets look like and what their sleep [patterns] look like, along with their stress levels. It helps them to see where things are.

We then bring them in again right after the course is done and give them the health information if they want it, and then we bring them back again four to six months later.

Wearable devices hold a lot of promise for biofeedback, particularly in measuring stress.

With mindfulness, we are trying to enhance our own ability to detect and to give ourselves biofeedback.

But, there are certain things that are difficult to measure; we can’t really feel our blood pressure all that well, we can’t really feel our heart rate all that well, and we can’t always detect our stress levels.

ConvergenceRI: Has mindfulness intervention techniques been employed to help combat substance use disorders and addiction to opioids?
LOUCKS:
Eric Garland, [the associate dean for Research and the director of The Center of Mindfulness and Integrated Medicine at the University of Utah], is a friend and a collaborator. One of the things about The Mindfulness Center is that we are connected to some of the top researchers around the country.

Garland has developed a customized mindfulness intervention that he calls “savoring.” It is like a substitution therapy, using mindful awareness to be able to direct his participants’ attention to the things that fill them up, that activate the [body’s] endogenous opioids, whether it is being with loved ones, eating healthy food, or getting exercise, all the naturals ways that the body has been designed to allow for endogenous opioids to be released.

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