Integrative biology for integrative medicine: A complete approach.

BACKGROUND: India's AYUSH systems of medicine, Ayurveda, Yoga and Naturopathy, Unani, Siddha and Sowa-Rigpa, and Homeopathy, use natural self-healing abilities of body and mind. Their ways to treat non-communicable diseases reduce use of modern drugs with their side-effects. Scientific acceptance requires them to be explained from a modern biological perspective. This paper indicates how to achieve such an integrative approach, using aspects of biology not yet taught in medical schools. METHODS: A new, 'Sandwich Model' of biology is introduced that includes holistic epigenetic regulation; also, complexity biology's concept of self-organized criticality; a systems treatment of organism function from Ayurveda; and Ayurveda's six stages of etiology, Shadkriyakala. RESULTS: Molecular biology is upgraded by the sandwich model's layer of epigenetics, leading to a new, scientific definition of health as optimized regulation. Fractal Physiology then expands this to explain self-healing, used in all AYUSH systems. Ayurveda contributes in two ways: its systems approach yields a holistic understanding of organism functioning, while Shadkriyakala improves our understanding of pathophysiology. DISCUSSION: These additions create an integrative biology; modern biology expands to include AYUSH systems' concepts. It provides a scientific basis for India's plan for integrative medical education, with AYUSH systems treated as equal to modern medicine.

Impact of yoga breathing and relaxation as an add-on therapy on quality of life, anxiety, depression and pulmonary function in young adults with bronchial asthma: A randomized controlled trial.

BACKGROUND: The impact of combinations of yogic practices on bronchial asthma have been studied. Such yoga modules tend to be too lengthy for comfortable practice long-term, giving high dropouts. Returning to conventional medicine despite improvement is common. This study tested a shorter, easier yoga routine to improve asthma condition. MATERIAL AND METHODS: Sixty young adults aged 18-30 years diagnosed with bronchial asthma of mild to moderate severity were randomly assigned to the Yoga Group, add-on yoga therapy and continuing prescribed medication, or the Control Group, continuing prescribed medication only. Measurements on days 0 and 90, included Asthma Quality of Life Questionnaire, Hamilton Anxiety Rating Scale, Beck's Depression Inventory and Pulmonary Function Tests. The yoga therapy module, practised 30 mins daily, included four kinds of yoga breathing practices, and ended with guided relaxation. RESULTS: All Asthma Quality of Life subdomains improved greatly for the Yoga Group as did Hamilton Anxiety and Becks Depression Inventory scores, t statistics were high (40 -75), all p<.0001. Pulmonary Function also improved greatly in all variables, with smaller t statistics from 2 to 14. The Control Group showed some small improvements. Differences observed in scores were highly significant, with large effect sizes. Finally, no dropouts occurred. DISCUSSION: Zero dropouts represents an unprecedented result. The yoga module was completely acceptable to participants, Yoga Group improvements were highly significant. The study indicates that the new yoga module effectively improves quality of life, levels of anxiety, depression and pulmonary function in young adults with above-stated bronchial asthma.

Design and implementation of a highly efficacious new yoga breathing and relaxation protocol for asthma: A discussion and summary.

Asthma presents a global problem to health of high prevalence; often life-long, typical onset in late teenage years, and no hope of reversal. Also, problems of long-term management with drugs present patients with endless suffering: poor quality of life due to reduced pulmonary function and associated psychological problems. There is thus great need for more effective management, and identification of any possible route to cure. Yoga therapy offers a promising alternative. Studies of specially designed yoga protocols over the past 40 years have shown benefits for all the above problem areas. However, challenges have led to high dropout levels. Some postures may have been too difficult for all to perform, while overall yoga modules may have required too much time for all patients to practice regularly. Despite patients with asthma feeling that Yoga brings benefits, few have practiced it with enough persistence to gain control of their condition. This short communication summarizes two recent papers describing, (a) the development of a short, easy to practise yoga module, and (b) assessment of its efficacy in all three areas by a 90-day randomized control trial. The module's five carefully selected components include four breathing practices and a relaxation exercise, which could be done by anyone, even those new to yoga. Popularity with participants led to zero dropouts, while its efficacy proved extremely high in all areas assessed. These results also offer insights into developing further easily-practised yoga adjuvant therapy modules for chronic conditions other than asthma.

Vegetarian Diets, Ayurveda, and the Case for an Integrative Nutrition Science.

Two recent studies of the health effects of vegetarian diets reported conflicting results: the EPIC-Oxford study reported a significant increase in strokes among vegetarians compared to meat-eaters among a predominantly Caucasian cohort, while another, performed on Taiwanese Buddhists, reported significantly lower incidence of strokes among vegetarians. This was doubly puzzling given the pronounced decrease in cardiovascular events among the EPIC-Oxford group. In this article, we make a detailed comparison of the actual dietary intake of various food groups by the cohorts in these studies. We then use the nutritional principles of Ayurveda-traditional Indian medicine-to show how these apparently contradictory results may be explained. Systems of traditional medicine such as Ayurveda possess profound knowledge of the effects of food on physiology. Ayurveda takes into account not just the type of food, but also multiple other factors such as taste, temperature, and time of consumption. Traditional cuisines have evolved hand in hand with such systems of medicine to optimize nutrition in the context of local climate and food availability. Harnessing the experiential wisdom of these traditional systems to create an integrative nutrition science would help fight the ongoing epidemic of chronic lifestyle diseases, and improve health and wellness.

Yoga Practices as an Alternative Training for Physical Fitness in Children With Visual Impairment.

Physical activities provide fundamental benefits to children's health and well-being. They are vital for development and healthy life, but participation of children with visual impairment is limited. Herein, the authors report results of a 16-wk yoga program, evaluating its effects on physical fitness in children with visual impairment. Eighty-three children age 9-16 years (12.37 ± 2.19) participated in a 2-arm, single-blind wait-list-controlled study at a residential school in south India. Participants (yoga group 41, controls 42) were assessed on muscle strength, flexibility, endurance, coordination, and respiratory health. Significant improvements in physical fitness were observed after the yoga intervention (Group × Time interactions for right-hand grip strength, p < .001; sit-up, p < .001; sit and reach, p < .001; bilateral plate tapping, p < .001; and peak expiratory flow rate, p < .001). Left-hand grip strength showed main effects of time, although there were no Group × Time interactions. Results demonstrate yoga's ability to improve a wide range of physical variables in children with visual impairment.

Association between Cyclic Meditation and Creative Cognition: Optimizing Connectivity between the Frontal and Parietal Lobes.

BACKGROUND: Important stages of creativity include preparation, incubation, illumination, and verification. Earlier studies have reported that some techniques of meditation promote creativity but have not specified which stage is enhanced. Here, we report the influence of cyclic meditation (CM) on creative cognition measured by a divergent thinking task. Our aim was to determine the degree of association between the two. METHODS: Twenty-four university students were randomly assigned to an experimental group (CM) and controls (Supine Rest), 35 min/day for 7 days. Creativity performance was assessed pre and post using Abbreviated Torrance Test for Adults (ATTA), while 64-channel electroencephalography (EEG) was used to measure brain activity during both CM/SH and the creativity test. RESULTS: Results indicated that CM training improved creativity performance, producing a shift to predominant gamma activity during creativity compared controls who showed delta activity. Furthermore, the experimental group showed more activation of frontal and parietal regions (EEG leads F3, F4 and P3, P4) than controls, i.e., the regions of the executive network responsible for creative cognition, our particular regions of interest where specialized knowledge is being stored. CONCLUSION: Improvement on creativity test performance indicates that CM increases association and strengthens the connectivity between frontal and parietal lobes, the major nodes of default mode network and executive attention network, enhancing the important stages of creativity such as preparation, incubation, and illumination.

Effect of Yogic Breathing on Accommodate Braille Version of Six-letter Cancellation Test in Students with Visual Impairment.

CONTEXT: Attentional processes tend to be less well developed in the visually impaired, who require special training to develop them fully. Yogic breathing which alters the patterns of respiration has been shown to enhance attention skills. Letter cancellation tests are well-established tools to measure attention and attention span. Here, a modified Braille version of the six-letter cancellation test (SLCT) was used for students with visual impairment (VI). AIM: This study aimed to assess the immediate effects of Bhramari Pranayama (BhPr) and breath awareness (BA) on students with VI. METHODS: This study was a self-as-control study held on 2 consecutive days, on 19 participants (8 males, 11 females), with a mean age of 15.89 ± 1.59 years, randomized into two groups. On the 1st day, Group 1 performed 10 min breath awareness and Group 2 performed Bhramari; on the 2nd day, practices were reversed. Assessments used a SLCT specially adapted for the visually impaired before and after each session. RESULTS: The Braille letter cancellation test was successfully taken by 19 students. Scores significantly improved after both techniques for each student following practices on both days (P < 0.001). BhPr may have more effect on attention performance than BA as wrong scores significantly increased following BA (P < 0.05), but the increase in the score after Bhramari was not significant. CONCLUSIONS: Despite the small sample size improvement in attentional processes by both yoga breathing techniques was robust. Attentional skills were definitely enhanced. Long-term practice should be studied.

Combined Ayurveda and Yoga Practices for Newly Diagnosed Type 2 Diabetes Mellitus: A Controlled Trial.

BACKGROUND: The increasing prevalence of type 2 diabetes in India is a cause for national concern, particularly the spiraling cost burden to the country. As one approach to stop its increase, Yoga medicine has been widely implemented, finding popularity with all social strata. Here, we report a study suggesting that treatment with fresh herbal juices and Yoga can improve the levels of blood glucose and hemoglobin A1c (HbA1c) in people with pre-diabetes. METHODS: Study design: 3-arm controlled trial 3 months in duration. PARTICIPANTS: 157 male prisoners with newly diagnosed, high fasting blood sugar (FBS) and postprandial blood sugar (PPBS) levels. Group interventions: (1) Rasahara and Yoga, (2) Yoga, (3) no intervention. ASSESSMENTS: FBS and PPBS levels were measured every 2 weeks; HbA1c and blood lipids were determined pre- and post-intervention. RESULTS: Significant decreases occurred in the FBS (-21.13 ± 21.16 mg/dl) and PPBS levels (-15.02 ± 14.89 mg/dl) in group 1 (both p < 0.0001) and in the FBS level (20.62 ± 32.68 mg/dl) in group 2 (p = 0.0005), while the increases in group 3 attained significance only for the PPBS level (9.62 ± 21.83 mg/dl) (p = 0.0022). Observed changes in HbA1c were: group 1, -0.044 ± 0.059 mg/dl; group 2, +0.024 ± 0.456 mg/dl (not significant); and group 3, +0.365 ± 0.369 mg/dl (p < 0.0001). CONCLUSIONS: This study of Yoga for the treatment of diabetes shows that all male prisoners could benefit from the Yoga prison programs. Addition of Yoga programs to state and federal activities at all levels is now national policy in India. Follow-up studies should be carried out to obtain more robust results.

Experience information as the basis of mind: Evidence from human decision making.

Study of product diversity by companies and corporations led to the discovery of a new statistical distribution, the (1/f) distribution, assessed according to the Herfindahl-Hirschman index. Products of human creative thinking and decision-making seem to obey the index very widely or universally. This article explores examples of its applications in business and economics as evidence for a new scientific conjecture concerning the physiological basis of Mind: that mind functions from critical instabilities in the brain physiology. Instabilities result in (1/f) distributions of physiological responses, so the two sources of (1/f) distribution present interesting parallels. Without comprehensively reviewing all Herfindahl-Hirschman index applications, many similar examples of (1/f) distributions are considered: those in numbers of divisions and subdivisions within big corporations, and numbers of corporations in industrial sectors. Evidently, this kind of distribution derives from individual and collective creative work. The paper reasons that it reveals important evidence about the conjectured basis of mind and its creative capacities. A previous Special Issue paper showed that many of the mind's properties, including self-awareness, result from critical instabilities being the loci of control of biological systems. A consequence of such instability is that when faced by several identical stimuli, the physiology offers a (1/f) distribution of responses. Studies described here showing that creative thinking produces (1/f) distributions of results may thus be considered a first round of direct evidence for the mind functioning from critical instability. Physical systems producing (1/f) distributions do not have that implication. Other cybernetic systems may behave differently.

Electrodermal Screening of Asthmatics with AcuGraph 4.

Traditional Chinese Medicine holds that acupuncture meridian activity is correlated with quality of function of specific organs. This study sets out to determine acupuncture meridian characteristics of subjects with moderate asthma distinguishing them from healthy subjects. Fifty asthma patients (age 35.36 ± 8.68 years) and fifty similarly aged (34.11 ± 7.29 years) healthy volunteers were enrolled in the study. Electrodermal conductances at Jing Well points were measured with Acugraph 4 and also Peak Expiratory Flow Rate (PEFR) for the asthma group. All mean meridian conductances were lower for the asthma group, significance differences were in Lung and right Bladder meridians. In contrast, all but two of the standard deviations of group meridian conductances for the Asthma group were higher than those for the Healthy group. Difference in mean PEFR values between Asthma and Healthy groups was significant. These suggest that group measures of electrical conductance at Jing Well points can distinguish asthma from healthy individuals. The study provides support for the usefulness of meridian energy measurements to assess organ related dysfunction and for the idea that pathology groups exhibit higher standard deviations i.e. lower quality of regulation.

Effect of Lotus Posture on Acupuncture Meridian Energies: A Controlled Trial.

BACKGROUND: Many studies have assessed Yoga practices using instruments such as AcuGraph, which measures conductances at Jing-Well points of acupuncture meridians. Such studies find that participation in Yoga programs ranging from a weekend to many months systematically increases subtle energy. Here, we report comparison of Jing-Well point conductances before and after sitting in Lotus Posture with those before and after sitting in a chair. METHODS: This was a controlled study conducted on 52 male Yoga practitioners (mean age in years 23.03 ± 3.23), all with >1 year experience of Yoga practices. Participants were alternately assigned into two groups, sitting in Lotus Posture and sitting in a chair. Each was measured on 3 successive days, before and after sitting as instructed for 10 min on the 1st day, 20 min on the 2nd day, and 30 min on the 3rd day. RESULTS: The two groups yielded completely different results: those sitting in Lotus Posture for 30 min showed increases in subtle energy levels (E_Ls) in all acupuncture meridians; those sitting in chair produced universal decreases. Results for 10 and 20 min showed how these changes in energy values took time to build up with increasing time. CONCLUSIONS: Sitting in Lotus Posture is held to strongly stimulate subtle E_Ls, so results agreed with the experimental hypothesis. Nevertheless, decreases in E_Ls of those sitting in a chair were surprising since the rest might be expected to have no effect.

Acupuncture Meridian Energies in Patients Who Are Mentally Disturbed.

BACKGROUND AND OBJECTIVE: Acupuncture medicine states that different pathologies exhibit different patterns of excitation in the 24 main acupuncture meridians. Previous exploratory work has shown that groups of patients with the same pathology exhibit such characteristic patterns when limited numbers of acupuncture points are measured with the AcuGraph meridian energy measuring device. This study reports patterns of meridian energies observed in an exploratory assessment of different classes of patient with mental disturbance. METHODS: This study was a three-group cross-sectional design. Participants were patients who had been diagnosed by their GP with anxiety (n = 21) and depression (n = 26) and who were entering a treatment program, along with age- and sex-matched controls (n = 44). Patients diagnosed with mild mental disturbance who were aged 20-50 years were eligible to take part. Patients with any cut, wart, or mole on their fingertips or with excess sweating, which would interfere with conductance measurements, were excluded. The assessment comprised conductance values at Jing-Well acupuncture points by AcuGraph4 on entry into the treatment program. RESULTS: Patients with anxiety had higher meridian energy levels (81.84 ± 38.63) and significant Upper-Lower imbalances (p < 0.05) favoring the upper meridians. Patients with depression had lower energy levels and lower standard deviations (53.36 ± 33.48) as a group. Controls exhibited intermediate energy levels but recorded the lowest scoring variances (62.61 ± 27.05) of the three groups. Kidney meridians had the lowest energy for both of the pathology groups. For the group suffering with anxiety, bladder meridians were also low. CONCLUSION: Higher variances in AcuGraph4 measurements were observed in patients with either anxiety or depression compared with controls whose variances were the lowest. These results are in accordance with previous observations of greater variance in conductance values in pathology groups. With regard to meridian energies, the lowest were in those with depression, while those with anxiety were the highest. Controls exhibited intermediate energy levels.

Acute effects of mobile phone radiations on subtle energy levels of teenagers using electrophotonic imaging technique: A randomized controlled study.

BACKGROUND: Mobile phones induce radio frequency electromagnetic field (RF-EMF) which has been found to affect subtle energy levels of adults through Electrophotonic Imaging (EPI) technique in a previous pilot study. MATERIALS AND METHODS: We enrolled 61 healthy right-handed healthy teenagers (22 males and 39 females) in the age range of 17.40 ± 0.24 years from educational institutes in Bengaluru. Subjects were randomly divided into two groups: (1) (mobile phone in ON mode [MPON] at right ear) and (2) mobile phone in OFF mode (MPOF). Subtle energy levels of various organs of the subjects were measured using gas discharge visualization Camera Pro device, in double-blind conditions, at two points of time: (1) baseline and (2) after 15 min of MPON/MPOF exposure. As the data were found normally distributed, paired and independent samples t-test were applied to perform within and between group comparisons, respectively. RESULTS: The subtle energy levels were significantly reduced after RF-EMF exposure in MPON group as compared to MPOF group for following areas: (a) Pancreas (P = 0.001), (b) thyroid gland (P = 0.002), (c) cerebral cortex (P < 0.01), (d) cerebral vessels (P < 0.05), (e) hypophysis (P = 0.013), (f) left ear and left eye (P < 0.01), (g) liver (P < 0.05), (h) right kidney (P < 0.05), (i) spleen (P < 0.04), and (j) immune system (P < 0.02). CONCLUSION: Fifteen minutes of RF-EMF exposure exerted quantifiable effects on subtle energy levels of endocrine glands, nervous system, liver, kidney, spleen, and immune system of healthy teenagers. Future studies should try to correlate these findings with respective biochemical markers and standard radio-imaging techniques.

Investigation of Yoga Pranayama and Vedic Mathematics on Mindfulness, Aggression and Emotion Regulation.

BACKGROUND: Competitive examinations, particularly in mathematics, have made emotional stress a major problem for preuniversity students, emotions like aggression toward fellow students and teachers increase. Mindfulness is a quality that reduces both emotional stress and aggression, so increasing mindfulness should be helpful. AIMS: To study the effects of Yoga Pranayama (YP) and Vedic Mathematics (VM) on mindfulness, aggression, and emotion regulation. METHODS: Participants were 12th graders attending a preuniversity college in Chikkamagaluru, India, of both genders. Exclusion criteria included major psychological problems. Three classes were arbitrarily assigned to one of three interventions, which consisted of 15 days each of 30 min daily instruction in YP, Group 1, VM, Group 2, or 30 min ordinary class work, Group 3, the control group. Assessments were made using the Mindfulness Attention Awareness Scale, the Nonphysical Aggression Scale from Pittsburgh Youth Study, and the Emotion Regulation Questionnaire. STATISTICAL ANALYSIS USED: SPSS 19.0. RESULTS: Mindfulness, aggression, and negative emotional regulation changed significantly for the YP group, while mindfulness alone improved significantly for the VM group. No group changed on positive emotion regulation. Controls apparently improved on aggression. An interesting post hoc correlation analysis is also reported, among other things directly linking increased mindfulness to decreased aggression. CONCLUSIONS: The study showed positive effects of traditional methods of decreasing emotional pressure on students facing preuniversity mathematics examinations. Increasing mindfulness is considered a way of increasing emotion regulation, so the failure of this study to provide evidence for that is of interest.

Yoga-teaching protocol adapted for children with visual impairment.

CONTEXT: Childhood visual deficiency impairs children's neuro-psychomotor development, considerably affecting physical, mental, social, and emotional health. Yoga's multifaceted approach may help children with visual impairment (VI) to cope with their challenges. AIM: This study aimed to develop a special protocol for teaching yoga to children with VI, and to evaluate their preferred method of learning. METHODS: The study was carried out at Ramana Maharishi Academy for the Blind, Bengaluru, South India. Forty-one students volunteered to learn yoga practices, and classes were held weekly 5 days, 1 hr per session for 16 weeks. The study introduced a new method using a sequence of five teaching steps: verbal instructions, tactile modeling, step-by-step teaching, learning in a group, and physical guidance. A questionnaire concerning the preferred steps of learning was then given to each student, and verbal answers were obtained. RESULTS: A total of 33 (out of 41), aged 11.97 ± 1.94, 15 girls and 18 boys responded. Twenty-six (78.79%) chose physical guidance as their most favored learning mode. CONCLUSIONS: Specially designed protocol may pave the way to impart yoga in an exciting and comfortable way to children with VI. More studies are needed to further investigate the effectiveness of this new yoga protocol in similar settings.

A randomized controlled study on assessment of health status, depression, and anxiety in coal miners with chronic obstructive pulmonary disease following yoga training.

CONTEXT: Psychological comorbidities are prevalent in coal miners with chronic obstructive pulmonary disease (COPD) and contribute to the severity of the disease reducing their health status. Yoga has been shown to alleviate depression and anxiety associated with other chronic diseases but in COPD not been fully investigated. AIM: This study aimed to evaluate the role of yoga on health status, depression, and anxiety in coal miners with COPD. MATERIALS AND METHODS: This was a randomized trial with two study arms (yoga and control), which enrolled 81 coal miners, ranging from 36 to 60 years with stage II and III stable COPD. Both groups were either on conventional treatment or combination of conventional care with yoga program for 12 weeks. RESULTS: Data were collected through standardized questionnaires; COPD Assessment Test, Beck Depression Inventory and State and Trait Anxiety Inventory at the beginning and the end of the intervention. The yoga group showed statistically significant (P < 0.001) improvements on all scales within the group, all significantly different (P < 0.001) from changes observed in the controls. No significant prepost changes were observed in the control group (P > 0.05). CONCLUSION: Yoga program led to greater improvement in physical and mental health status than did conventional care. Yoga seems to be a safe, feasible, and effective treatment for patients with COPD. There is a need to conduct more comprehensive, high-quality, evidence-based studies to shed light on the current understanding of the efficacy of yoga in these chronic conditions and identify unanswered questions.

Yoga-based pulmonary rehabilitation for the management of dyspnea in coal miners with chronic obstructive pulmonary disease: A randomized controlled trial.

BACKGROUND: Coal mine dust exposure causes chronic airflow limitation in coal miners resulting in dyspnea, fatigue, and eventually chronic obstructive pulmonary disease (COPD). Yoga can alleviate dyspnea in COPD by improving ventilatory mechanics, reducing central neural drive, and partially restoring neuromechanical coupling of the respiratory system. OBJECTIVES: To evaluate the effectiveness of Integrated Approach of Yoga Therapy (IAYT) in the management of dyspnea and fatigue in coal miners with COPD. MATERIALS AND METHODS: Randomized, waitlist controlled, single-blind clinical trial. Eighty-one coal miners (36-60 years) with stable Stages II and III COPD were recruited. The yoga group received an IAYT module for COPD that included asanas, loosening exercises, breathing practices, pranayama, cyclic meditation, yogic counseling and lectures 90 min/day, 6 days/week for 12 weeks. Measurements of dyspnea and fatigue on the Borg scale, exercise capacity by the 6 min walk test, peripheral capillary oxygen saturation (SpO2%), and pulse rate (PR) using pulse oximetry were made before and after the intervention. RESULTS: Statistically significant within group reductions in dyspnea (P < 0.001), fatigue (P < 0.001) scores, PR (P < 0.001), and significant improvements in SpO2% (P < 0.001) and 6 min walk distance (P < 0.001) were observed in the yoga group; all except the last were significant compared to controls (P < 0.001). CONCLUSIONS: Findings indicate that IAYT benefits coal miners with COPD, reducing dyspnea; fatigue and PR, and improving functional performance and peripheral capillary SpO2%. Yoga can now be included as an adjunct to conventional therapy for pulmonary rehabilitation programs for COPD patients.

Self-transcending meditation is good for mental health: why this should be the case.

A simple theory of health has recently been proposed: while poor quality regulation corresponds to poor quality health so that improving regulation should improve health, optimal regulation optimizes function and optimizes health. Examining the term 'optimal regulation' in biological systems leads to a straightforward definition in terms of 'criticality' in complexity biology, a concept that seems to apply universally throughout biology. Criticality maximizes information processing and sensitivity of response to external stimuli, and for these reasons may be held to optimize regulation. In this way a definition of health has been given in terms of regulation, a scientific concept, which ties into detailed properties of complex systems, including brain cortices, and mental health. Models of experience and meditation built on complexity also point to criticality: it represents the condition making self-awareness possible, and is strengthened by meditation practices leading to the state of pure consciousness-the content-free state of mind in deep meditation. From this it follows that healthy function of the brain cortex, its sensitivity,y and consistency of response to external challenges should improve by practicing techniques leading to content-free awareness-transcending the original focus introduced during practice. Evidence for this is reviewed.