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Jul 26, 2017 · When a troubled world fuels fear in children


During the Cuban missile crisis, in 1962, schoolchildren (like myself) were taught to hide under our desks in the event of a nuclear attack. Some “lucky” kid’s parents were building bomb shelters.

I didn’t know the ins-and-outs—that the U.S.S.R had begun shipping nuclear missiles to Cuba that could easily target the U.S.­–but I heard enough  snippets of conversations between grown-ups, or  news updates on our black-and-white TV, that I was . . . concerned? Scared? Worried? I don’t recall. But it was enough to ask my parents why we weren’t building our own bomb shelter.

These days, fears can accumulate. Kids hear about bombings at rock concerts, vehicles mowing down innocents, or, in the U.S., shootings—lots of shootings (a nightclub in Orlando, a University in Virginia, Sandy Hook elementary school in Newtown, Connecticut, weekend killings in Chicago).

The threat of random acts of violence weighs on many adults (including, on average, the 3.5 children killed by guns every day in the U.S., with seven out of 10 shot intentionally).

But what about our kids? For them, anxiety and fear may percolate below the surface, says Melissa Brymer, the director of terrorism and disaster programs at the UCLA-Duke National Center for Child Traumatic Stress.  Brymer has worked as a lead advisor for families impacted by the Newtown shootings in 2012, and as a consultant for the city of San Bernardino, California, for the 2015 shootings that killed 14 and injured 22 employees of the San Bernardino Department of Public Health.  She is an expert on how children and adults deal with stress following disasters, including natural ones like earthquakes or tornados, or human ones, like shootings.

When it comes to sleuthing out how anxious or fearful your child may be feeling, step one, says Brymer, is to find out what your child knows. Just like adults, children’s personalities are on a spectrum. “Some kids have anxious personalities,” she says. “They pick up on the news or hear people talking, while others are oblivious about events taking place beyond their immediate world.”

That’s one reason parents need to censor their own conversations when younger children are in the room. “It’s cathartic for adults to talk out their worries with other adults, but we need to be sensitive and shield younger kids from these kinds of talks,” she says.

A few of the signs of high anxiety to look for are changes in a child’s personality, from “bubbly” to quiet, or from inquisitive to isolating. Other changes could be kids no longer wanting to go to favorite places like the park, a concert or movie, or becoming clingy and afraid of their old routines.

“It’s important to check in with kids, what are they thinking, what are their friends talking about? What are they hearing at school?” she says.

Smaller children, in particular, don’t handle a lot of information all at once. “Give kids basic information about what has happened, but you don’t need to give a lot of detail, unless your child can handle it.”

Timing is critical too. Bedtime? Not the best. “Don’t bring it up when you’re tucking your child in for the night; that conversation can be the stuff of nightmares,” says Brymer. “Better to talk at a time when you can focus on your child’s verbal and nonverbal responses, such as before dinner, perhaps driving somewhere in a car, a time when you are both able to plug into the conversation.”

And be honest, even when talking to young children. “Never say ‘it will never happen here’ because, of course, nobody knows; adversity can happen to any of us,” she says.

Use the appropriate language. “The words will be slightly different depending on the age of the child,” she says. Assure them you’re monitoring what’s happening in the world. Develop proper safety procedures at home, give them a safe place they can go to if something happens at home, and show them how to call authorities. “Take your kids to the local mall, their favorite restaurant, or a movie theater, and show them where the exits doors are and how to leave safely.” Highlight the safety plans and procedures at school.

If your child has personally experienced some type of trauma from an event, the best course of action is to give them time. “Healing is such an individualized experience. Some of it depends on past trauma or losses,” says Brymer. “We all have different coping strategies and personalities, even the youngest children.” It also depends on the type and frequency of reminders they are experiencing.

Older kids will behave differently. They may show more independence, pull away from family, perhaps be more irritable, have more angry outbursts, or even engage in risky behaviors, says Brymer.

One important factor to consider is the way in which children of many ages can easily access information, such as videos, and comments, such as text messages from friends, about traumatic events on their cellphones.

“A few days after the Manchester England attack in May 2017 there was video of bloodied bodies lying there dead; how is that impacting youth?” she asks. “And in the videos you could hear people—kids–screaming in fear and running. Hearing the actual sounds of Manchester, says Brymer, seeing the violence as opposed to just reading or having someone tell you about it, takes it to a “whole other level of gravity,” she says. ”It’s not a TV show anymore; it’s real life. It puts it into a reality, a context, and creates more fear.”

Social media poses another challenge for parents. It’s important to know how your children are using social media and to talk with them about the pros and cons of information they view on Facebook and other sites. “We need to help our kids be critical thinkers and know they can’t trust everything that we see on social media,” Brymer says.

Parents and teens may not always have the best relationship, and a conversation could reach a sticking point in which a teen flatly refuses to talk about their feelings. In such cases, it’s important that the teen have someone in their lives they are comfortable speaking with. “I had a situation where a mom had triplets, and the kids wouldn’t talk to her, but they did to me,” says Brymer. “So it doesn’t have to be the parent. It could be a grandparent, an uncle or aunt, a coach or pastor.”  Even if your teens don’t want a detailed conversation, ask what is reminding them of the event and discuss a plan for you to help them cope when those reminders occur.

Still, says Brymer, parents, should never give up on trying to communicate with their children even when they are met with resistance. “So persevere, and try again in a couple of days,” says Brymer. “Keeping the lines of communication is vital, and sometimes it’s hard work.”

Jun 19, 2017 · Teen suicide: Why "13 Reasons Why" is wrong

Courtesy National Institutes of Health/ Eric Lefebre

Say what you want about the Netflix series “13 Reasons Why” – you’ll have plenty of company regardless – but if you’re the parent of a teenager, the show should provide a pop culture wake-up call about teen suicide.

In 2014, suicide was the secondleading cause of death for people ages 10-24, second only by accidents. Moreover, the numbers could have been even worse – a recent CNN report noted a sharp increase in the number of children admitted to children’s hospitals due to attempts or thoughts of suicide.

“These facts are very concerning and call for the critical importance of knowing how to recognize signs that someone is feeling unbearable pain and at risk for suicide or suicide attempts – and, importantly, respond in ways that support and protect that individual,” says Joan Asarnow, a professor of psychiatry at the UCLA David Geffen School of Medicine and an expert on youth suicide prevention.

As the mother of two and a clinical psychologist, Asarnow knows personally and professionally of what she speaks. In fact, she specializes in treating adolescent mental health issues; founded and directs the UCLA Youth Depression and Suicide Prevention program; and directs the Center for Trauma-Informed Suicide and Self-Harm Prevention, part of the National Child Traumatic Stress Network funded by the Substance Abuse and Mental Health Services Administration.

Suicide and suicide attempts don’t have a single cause, Asarnow says. Biology – hormones, genes, and changes associated with development – play a role. So too does the broad range of stresses that kids face, ones that may appear to adults to be “small stuff,” yet loom large in the lives of teens. These include rejection by a friend, a slight via social media, depression over a bad grade, a fight with a parent, a romantic break-up, and other stressors.

“Any one of these can overwhelm a teen’s abilities to cope, at times leading to what feels like unbearable pain, hopelessness, and a feeling that their problems are unsolvable,” Asarnow says.

‘Cancer of mental disorders’

Based on a best-selling novel, “13 Reasons Why” tells the fictional story of high school student Hannah Baker, who takes her own life after creating 13 recordings that target those she considers responsible. The recordings have an enormous impact on their subjects, just as Hannah intended.

Because of her death, Asarnow points out, Hannah never has the opportunity to develop into the talented, sensitive, and beautiful young adult she could clearly have become. Her parents are tortured by her death.

“I would have really liked the series to have shown what Hannah herself lost,” Asarnow says. “Yes, she removed herself from the pain and stress. But she lost so very much of what could have been. I have spoken with many suicide attempt survivors who went on to build lives they wanted to  live with purpose and joy and yes pain at times – yet they learned that getting through the pain was worth it.”

Because teens can find it difficult to reach out to parents, counselors and others in their lives for help, Asarnow says, adults must be especially sensitive to any marked changes in behavior, mood and what the teen says, all of which can be warning signs. Parents should reach out for professional guidance if they have any concerns at all.

“Don’t leave a teen alone if you have any concerns about their safety,” Asarnow says, “and restrict access to dangerous and potentially lethal means of self-harm.”

Joan Asarnow, professor of psychiatry and director, UCLA Youth Depression and Suicide Prevention program.

Parents and others who care for teens, young adults, and younger children need to be aware that “13 Reasons Why” includes vivid scenes of rape and suicide, which has led to widespread worries that the series glamorizes teen suicide rather than showing that suicide is never a solution. Yet, despite its potentially negative impact, the series is now in its second season.

Suicide is an irreversible choice to a temporary problem – something that many teens can’t fully grasp – and presenting the series without messaging to remind viewers of that fact is a lost opportunity with potentially tragic consequences, Asarnow says. Help is available,  and the show should offer links to crisis services (such as the National Suicide Prevention Lifeline (800 273- TALK (8255), or text START (741741); chat services are also available).

“Remember: Research shows that family-centered interventions for youths with suicidal tendencies tend to be our most effective,” Asarnow says. “So watch, listen, and strive for open and honest communication with your child. Don’t be afraid to remind your child how much you love them, that you are a team,  there’s nothing your child can’t tell you, that everyone makes mistakes, and you will always be there for them no matter what they do or suffer.”

Asarnow calls suicide the “cancer of mental disorders” that can come on quickly. Know the signs, she says.  She encourages parents to make sure they are engaged with their kids. “Again, listen!” she says.

“Communication is an absolute key. Let your kids know no problem is too big we can’t solve together,” she advises, “and if you suspect something, don’t leave them alone.”

Know the warning signs

Suicide can be prevented with intervention, Asarnow says. She urges parents and adults to take all potential warning signs seriously, noting that parents know their kids best. Any change, even a mood change that appears to be an improvement, should be taken seriously as it could be an indication that a teen has made a decision to end his/her life. She highlights the following as potential red flags:

  • Talk of death or suicide, both direct (“I am going to kill myself”) and indirect (“I wish I could fall asleep and never wake up”; “I’m done”; “There’s no reason to live”). Such talk can be verbal, written, or posted online.
  • A preoccupation with death  in conversation, writing, drawing, social media or choice of movies or television shows
  • Changes in appearance/hygiene
  • Emotional distress
  • Talk of being a burden to others
  • Feeling trapped
  • Experiencing unbearable pain
  • Changes in thoughts, feelings or behavior, including giving things away and writing “good-bye notes”
  • Increased use of alcohol or drugs
  • Seeking information about methods of suicide
  • Acting recklessly
  • Withdrawal from activities
  • Isolation from family and friends
  • Sleeping too much or too little
  • Aggression
  • Changes in mood, such as increased depression, loss of interest in activities, rage, irritability, humiliation, anxiety

Looking forward

As to treatment, says Asarnow, “we really need a multi-pronged approach. We need better treatments, we need to get information out to clinicians and parents about treatments we know that work like cognitive behavioral therapy, and we need to regularly follow up with people receiving treatment.”

Asarnow is the principal investigator on three separate grants to do just that. One, funded by the National Institute of Mental Health, is a clinical trial of advanced suicide prevention techniques. A second, supported by Substance Abuse and Mental Health Services Administration, develops a national suicide and self-harm prevention center to train health care providers in the treatment and prevention of suicide and self-harm risk. Another, funded by the American Foundation for Suicide Prevention, focuses on the role of sleep problems as a marker of suicide risk and the impact of sleep problems on increasing suicide risk.

Help for parents and children can be found through UCLA’s Youth Stress and Mood Program which Asarnow directs. See:


May 4, 2017 · Cyberbullying: Don’t feed the trolls!  


A recent story on National Public Radio cited an academic study that suggested many teenage girls in the U.S. may be experiencing more serious depression than boys. And while the usual stressors for teens no doubt still apply—academics, hormones, parents—another increasing reason may be their obsession with social media.  And social media sites such as Facebook, Instagram or Snapchat are often the places where teens are confronted with the issue of bullying.

According to another study, cyberbullying may have increased more among girls than boys, simply because adolescent girls use social media more frequently and intensively. And problems with mobile phone use has been linked to depression. Further, recent data on trends in suicide in the United States show a greater increase among adolescent girls and young women,

Elizabeth Laugeson, a UCLA assistant clinical professor of psychiatry, has developed strategies to blunt cyberbullying. She is the founder and co-developer of the UCLA PEERS Clinic, or Program for the Education and Enrichment of Relational Skills, the only research-supported treatment programs for improving social skills for preschoolers, adolescents and young adults with autism spectrum disorder. Her recently published book, “PEERS for Young Adults,” is based on the success of that program.

The cyberbullying strategies she’s devised for adolescents with autism work just as well for people who are not autistic, she says. “Our research has looked at what teens have used that work to offset bullying. We’ve found that responding is simply not effective because none of the emotional impact of a verbal comeback comes across online.”

And while nobody knows for sure the intent of cyberbullies, she says, it’s probably related to negative attention seeking, kids who are hoping to get a reaction from their victims. So the first defense, Laugeson suggests, is simple—“don’t feed the trolls.”

Internet trolls is the common phrase used for people who post insulting and mean comments online. “If you debate them, or defend yourself, you’re doing exactly what they want,” Laugeson says. “You’re feeding them, and making it more likely you’ll be cyberbullied further. Hard as it may be, if you ignore them and don’t respond, they’ll probably get bored, and move on to someone else.”

So while it won’t work if you try to defend yourself, another effective strategy is to have a friend or friends stick up for you.  “Physical bullies like to target kids who are isolated because it’s easier. If you’re in a group, even a cyber group, others around you may come to your defense,” says Laugeson. “Bullies are cowards; they don’t want to attack someone who comes equipped with a strong defensive line.”

Two other defenses—block the bully from whatever social media you are using, and lay low for a while; stay offline. “Both of these strategies create distance between you and the bully. If he or she can’t find you in cyberspace, chances are good they’ll move on to someone else,” says Laugeson.

Finally, she says, save the evidence, and keep screenshots of all forms of messages. “If it escalates to an online barrage of bullying,” she says, “it may be necessary to report it to your school, to your online service provider, or even to law enforcement. And proof helps.”

But caution is called for here, she says, and should be a strategy of last resort. If the bullying is not severe and just annoying, reporting could result in the person being bullied getting a bad reputation as a snitch. “So this is the point where a teen needs to discuss with a parent or adult to judge the necessity of this,” suggests Laugeson.

Laugeson offers additional tips to deflect bullies in her earlier book, The Science of Making Friends. A video can be seen here:

And who can forget the “Mean Girls” movie starring Lindsay Lohan about cliques, put-downs, and outcasts? Laugeson discusses strategies against that type of bullying in a video here:

Finally, more on the UCLA PEERS program can be found here.

Mar 30, 2017 · How to get a date--For young adults with autism, it's not so easy

For children with autism spectrum disorder, understanding emotions is a very difficult task. These children typically have trouble recognizing emotions, particularly social emotions conveyed through facial expressions — a frown, a smirk or a smile. This can hamper the child’s ability to communicate and socialize, sometimes leading to social isolation.

And as the child with autism spectrum disorder, or ASD, becomes a young adult, the impact of these social difficulties can make it more difficult to find friendships—and romance.

“Many people tend to think of autism as a childhood disorder,” says Elizabeth Laugeson, a UCLA assistant clinical professor of psychiatry and autism expert. “It’s as if we’ve forgotten these children grow up to be adults with the same unique challenges that very often affect their ability to be gainfully employed or establish meaningful friendships and romantic relationships.”

While we’ve all suffered from social angst—maybe being tongue-tied on a date, or not quite fitting in at a party or social gathering–eventually we learn how to engage, talk, and blend in.

But for a young adult with autism, it goes something like this, says Laugeson. “Imagine a young man who, say, is interested in the barista at the local Starbucks. How will he show his romantic interest? He may sit at a table for hours and just stare at the person continuously. He means no harm, of course, just the opposite, but what will people, and the poor barista, think? They’ll think it’s creepy. He may even get in trouble for the awkward gesture.”

“Most of us know the social world lacks a “manual,” and most of us learn through trial and error over time how to adapt to various social situations,” she says. “But the rules governing the social world are complex, subtle and implicit, and adults on the autism spectrum miss those cues.”

For the guy who stares too long, Laugeson has an antidote: teach him, literally, how to flirt with his eyes. In the training she does with young adults with ASD, Laugeson would teach the guy in much detail how to flirt by using an initial brief glance, brief eye contact, slight smile (show no teeth!), look away, and repeat—a series of actions that naturally convey romantic interest, but do not always come naturally to people with autism.

Laugeson is the founder and co-developer of The UCLA PEERS Clinic (Program for the Education and Enrichment of Relational Skills), the only research-supported treatment program for improving social skills for children and young adults with autism.

For the young adults, the classes help improve conversation skills, how to use humor and social media, find friends and organize social gatherings, and handle conflict and rejection.

Laugeson has published several books, including PEERS® for Young Adults, which is based on the success of these programs. The book is a step-by-step manual geared for mental health professionals and educators to use in helping adults with autism navigate through social interactions.

The book gets down to specifics. How to ask someone on a date. How to let someone know you’re interested. How to plan a date using the five “W’s”—who will be there, what you plan to do, when, where, and how you will make it happen. (Okay, four W’s and an H.) Other sessions are similar to what is taught in the actual classes, such as how to use humor or interact on social media.

“We’ve shown through our research that social skills can be learned, in much the same way people can learn a foreign language,” says Laugeson. “In fact,” she laughs, “I can’t tell you the number of people who don’t have autism who’ve said they wished they had such a manual!”

Indeed, for people who would just like to be more socially adept, Laugeson published an earlier book, The Science of Making Friends, to teach socially challenged teens and adults the science behind making and keeping friends. More information on the PEERS® program can be found at

Jul 29, 2016 · Fish really love to eat plastic, and that's a problem for all of us

Fish really love to eat plastic, and that’s a problem for all of us

The Great Pacific Garbage Patch bobs in the central North Pacific, trapped by rotating ocean currents. It is one of five such patches in the world’s oceans, and consists primarily of microscopic particles, mostly plastic, suspended in the upper water column.

Indeed, more than 5 trillion plastic pieces weighing more than 250,000 tons are afloat at sea, according to an article published in the December 2014 PLOS ONE.

Fish ingest these particles. And then we eat the fish.

“Fish love to eat plastic, and that’s a problem,” says Dana Hunnes, a dietitian at the Ronald Reagan UCLA Medical Center. Writing in the Huffington Post, Hunnes notes that microscopic bits of plastic are ubiquitous. They are in our food, in our beverages — “they’re everywhere,” she says, including the far-reaches of the oceans.

Hunnes cites a statistic from the United Nations Environment Programme that says 30 percent of all fish have plastic in them.

It’s almost certain that most fish (and in fact, most marine animals) have chemical byproducts from plastic in their blood stream and stored in their fat, where the material accumulates in the fish and is passed up the food chain – eventually to us.

Here’s how the plastic progression works: Small marine species feed on micro-plastic bits (much smaller than pearls) thinking they’re food. These bits can come from micro-beads in soaps and other cosmetic products, and from larger pieces of plastic that have been ripped apart by ocean currents. Larger fish and marine animals then dine on the smaller fish.

“By the time fish and other seafood winds up on your plate” Hunnes writes, “whether ‘sustainably’ caught, farmed, or wild, they are sure to have detectable levels of BPA, Bisphenol A (a byproduct of plastic); phthalates, a chemical component of PVC plastic; vinyl chloride, another component of PVC; dioxins; or styrene, also components of plastic and rubber. Unfortunately for these animals and for all of us who eat fish and other seafood, these chemicals are carcinogens, possible carcinogens, or promoting other negative health effects via their endocrine-disrupting pathways.”

To reduce exposure to such compounds, Hunnes offers some suggestions:

  • First, reduce your use of plastic.
  • Store food in glass or stainless steel as much as possible.
  • Skip the plastic lid on a single-use coffee cup too. Better yet, bring your own reusable cup. You may even get a discount.
  • Try to buy jarred vegetables instead of canned to avoid the BPA-filled lining.
  • Limit your contact with thermal receipts (cash-register receipts contain BPA).

None of these tips can hurt, and they might make the oceans – and ourselves – healthier.

Jun 29, 2016 · 5 tips for a healthy gut. They’re in your head’s best interest


Pay attention to your stomach. A healthy stomach will make for a better brain. That’s because inside your gut — indeed, in and on your entire body — is what scientists call our microbiome—composed of fungus, bacteria, viruses, and other microorganisms.

It’s estimated that these organisms number around 100-trillion or so, but they’re not just passengers. These critters actually work to keep us healthy. Alas, they can also make us sick if out of whack.

Dan Gordon, writing for U Magazine, the publication for the David Geffen School of Medicine, notes that at UCLA alone, recent findings in this nascent field of study suggest a role for microbiota beyond what anyone might have imagined even a decade ago. UCLA scientists have:

• Revealed that the presence of a byproduct of gut bacteria is a risk factor for heart disease on par with high cholesterol, hypertension and tobacco use;

• Found that the beneficial bacteria in food — so-called probiotics, in this case ingested through regular consumption of yogurt — can positively affect brain function;

• Shown, through studies by Elaine Hsiao, that manipulating the microbiota can ameliorate behavioral abnormalities in a mouse model for autism.

The field is promising, says Dr. Kirsten Tillisch, a UCLA associate professor in the Division of Digestive Diseases, and chief of Integrative Medicine at the Oppenheimer Family Center for the Neurobiology of Stress in the Geffen School. She’s a pioneer in the study of how changing the bacteria environment of the gut can affect human brain function. She is currently exploring the potential of mind-body interventions, such as hypnotherapy, acupuncture and mindfulness-based stress reduction, to ease gastrointestinal disorders.

As a clinician, she focuses on patients with irritable bowel syndrome (IBS), which causes chronic abdominal pain, diarrhea and/or constipation. Although there’s no cure, mindfulness seems to ease the symptoms. The practice is simply about paying attention to the present, not reliving the past or worrying about the future.

“When people are having an attack, they tend to worry about how bad it will be, they remember their worst attack, they wonder how long this attack will last,” says Tillisch. “All of this impacts how the gut will function. Mindfulness teaches them to only focus on the present symptoms, and not catastrophize.”

She’s found that regular practice of mindfulness can make people feel better, reducing bowel symptom severity and stress, and generally improving quality of life.

Tillisch has also done research on probiotic bacteria in yogurt and the impact it may have on the brain. She and her colleagues found, using MRIs of the brain, that healthy women who were part of the study and who ate yogurt were calmer when exposed to images of angry and frightened faces. Researchers actually saw a change in the way the brain responded on a subconscious level.

“The bacteria that live in our gut communicate through the gut to the nervous system to the brain, and it’s a back and forth conversation,” explains Tillisch. “Gut bacteria can adjust to how we feel pain and how we secrete fluid into the gut and how the gut works.”

For all of us, Tillisch offers five tips to keep our guts healthy:

First, choose a healthy diet, meaning lots of fruits and vegetables and not a lot of meat.

Second, exercise. A healthy body will help maintain a healthy gut.

Third, reduce stress. “We know stress can reduce the numbers of healthy bacteria in your gut.

Mindfulness comes into play here.”

Fourth, avoid antibiotics unless you really need them to treat an infection. They kill off the microbiome, and reduce its diversity.

Last, don’t bother with probiotics if your stomach is healthy. “If you don’t have stomach pain, you probably don’t need them,” Tillisch says.


Jun 7, 2016 · To reduce pain of irritable bowel syndrome, or IBS, focus on the now


Mindfulness is everywhere these days, backed by science and shown to be helpful in lowering your blood pressure and beating back depression, decreasing your anxiety and increasing attention and focus, even fostering what scientists describe politely as less “emotional reactivity” and the rest of us would call fighting with your significant other.

It’s something anyone can do. It’s free, no prescription or doctor’s appointment necessary. Mindfulness is simply paying attention to the present, perhaps by concentrating on your breathing–in. . .out. . .in. . .–and not reliving something you screwed up in the past, or worrying about something you might screw up in the future. You can do it in your home, you can do it while practicing yoga, heck, you can do it when you go for a run (inoutinout).

Dr. Kirsten Tillisch is a UCLA associate professor in the UCLA Division of Digestive Diseases. She does guts—both as a clinician and a scientist, treating people with such disorders as irritable bowel syndrome (IBS), a nasty one that causes chronic abdominal pain, diarrhea, constipation or, particularly cruel, both. And, while there are some meds that help, there’s no cure.

Mindfulness is one tool that Tillisch and other researchers know can thwart IBS. Regular practice can make people feel better, reducing bowel symptom severity and stress, and generally improving quality of life. But last month at the annual Digestive Diseases Week (yes, there is one), Tillisch presented new mindfulness research showing that two specific aspects of mindfulness benefit people with IBS the most. (See a video interview with Tillisch courtesy of

In evaluating improvements in mindfulness, says Tillisch, the norm is to employ the Five Facet Mindfulness Scale, which measures distinct aspects of mindfulness — paying attention to the present moment, describing or labeling internal sensations, acting with awareness, not judging any inner experiences, and not reacting to inner experiences.

“Mindfulness-based stress reduction programs have been used for years, and nobody has really ever tinkered with it to see how it works for chronic pain disorders like IBS,” said Tillisch. “We hoped to identify some aspects of mindfulness that are most relevant to IBS to focus future treatment protocols.”

She and her colleagues showed that two aspects of mindfulness — labeling internal sensations and acting with awareness of your surroundings, improved the disorder’s symptoms.

Labeling means just that, giving a label to an inner sensation without judging it—“there is pain” as opposed to “I am in pain.” Acting with awareness means to stay within the present, and provided the most relief of symptoms.

“When people are having an attack, they tend to worry about how bad it will be, they remember their worst attack, they wonder how long this attack will last,” Tillisch said. “All of this impacts how the gut will function. Mindfulness teaches them to only focus on the present symptoms, and not catastrophize.”

By staying in the moment, she added, “seventy percent of our patients with IBS had a clinically significant drop in symptoms, even three months after completing the training.”

“This research helps to specifically refine the practice of mindfulness for our IBS patients,” Tillisch said. “That may lead to improved outcomes and a faster decrease of symptoms. That would, of course, be a relief to our patients.”