Mental Imagery and dystonia

Mental imagery and dystonia

Mental imagery is already used in high level sports competition, and athletes are trained to rehearse their race in their mind, to increase their performance.
Could dystonic patients benefit from mental imagery focusing on their motor
difficulties
?
There are scientific facts, and anecdotal reports from dystonic patients to suggest that it may be very helpful on the long term.
Real and mentally stimulated movements rely upon largely overlapping networks. In another words, writing or imagining writing involved common networks in our brain. Studies have shown that the mental imagery of a movement in patients with dystonia follows the same difficulties than the execution of the dystonic movement.
A study by Fioro, 2006 has looked at the mental rotation of body part (hands, feet) in which the subjects imagine moving their body part, from their actual posture into that seen on a picture to recognise which side is belonged in patients with writer’s cramp. Writer’s cramp patients are slower than controls in mentally rotating hands but not feet; it suggests that the mental rotation of body parts reflects the anatomical constraints of real hand movements.
Could the mind reshape the brain?
Neuroplasticity is a normal process by which the brain develops new connections at different levels, following interaction with environment, emotions, behavior. Dystonia is understood to be a condition characterized by an excessive neuroplasticity of the brain leading to abnormal learning of motor program. To be able to influence this brain plasticity It’s important to create an environment for positive learning and recovery.  Mindfulness can be helpful in patients with focal dystonia to minimise stress and increase well being before embarking for retraining.
Retrain your brain, not your muscles!
The visual and mental imagery training will encourage you to imagine successful, normal execution of tasks, which the dystonia prevents you to do..
Remember the time when you could perform the movement normally, and how easy it was to do it and the pleasure, which come with it.
It will be best performed after the Botox treatment has already controlled the dystonic spasm
in the affected body part and together with sensory retraining.
Visualisation exercises are not always easy and you may benefit of the advice of professionals such as hypnotherapist or specialized physiotherapist
Try daily to visualize yourself free of the dystonia, walking eye opened, turning your head freely looking around you, writing a page with our favorite pen or chewing a delicious meal.
Also music and melody can help you to IMAGINE…
You may say I’m a dreamer, But I’m not the only one, I hope someday
you’ll join us, And the world will live as one  (John Lennon)

Meditation and dystonia: an insight from a lady with blepharospasm

Meditation refers to a family of self -regulation practices that focus on training attention and awareness in order to bring mental processes under greater voluntary control and thereby foster general well-being and development and/or specific capacities such as calm, clarity and concentration.…( Walsh and Shapiro, 2006, quoted in Wikipedia on meditation http://en.wikipedia.org/wiki/Meditation
Several recent studies have shown the influence of mindfulness meditation on brain morphology. In particular, Britta et al (Soc Cogn Affect Neurosci. 2010; 5: 11–17) has shown the influence of an 8-week mindfulness-based stress reduction intervention on the changes in amygdaloid gray matter density, which is a part of the brain involved in response to stress.
Patients with dystonia have all experienced the worsening of their dystonic symptoms with stress and Henry Meige at the beginning of the 20th century adviced his dystonic patients to have a regular, calm life to avoid fluctuations in the severity of the cervical dystonia.
The dystonia itself is source of great frustration and stress for the patients, who are limited in their daily tasks (walking, reading, eating, speaking, writing) by the dystonics spasms. In addition, professional and family life can bring a lot of joy , but can be also emotionally challenging.
Can meditation help patients with dystonia? There is no scientific study on that topic but I want to share with you the testimony of Anne, a lady with blepharospasm who has been involved in teaching meditation to groups and practices mediation regularly for her well being.
 
Testimony of Anne 
“I have had Blephoraspasm for 7 years, for me the most difficult things to come to terms with were
Ø Loss of independence
Ø Loss of career
Ø Not being able to drive when I wanted
Ø Learning to use Public Transport alone
Ø Fear of travelling alone
Ø Decrease in social activities
I went through a period of becoming almost house bound only going out with my son and friends.
Having worked as a senior Nurse in Mental Health for over 40 years I was very aware of the symptoms of stress and anxiety but had not fully appreciated just how much these symptoms were affecting my Dystonia, I had spent years as a CPN teaching patients and carers Anxiety Management but had not recognised the tell-tale signs in myself
First I had to accept that I had this disabling disorder and that I had to learn to manage the symptoms, I soon became more and more aware that any sort of negative stress or anxiety made the symptoms a great deal worse. It could be something really trivial and my eyes would start closing.
To assist me with relaxation I tried many different complementary therapies some helped some didn’t, we are all individuals, what will help one person won’t another. I also used anxiety management techniques to help, particularly when I went out i.e. shopping.
I also tried to develop new activities/hobbies that I could do rather than dwell on those that I had lost [not easy]
I had been interested in Meditation for many years and although I had practised this, it had not been in a very disciplined way, now I aim to sit for 30 minutes once or twice daily.
There are many different types of meditation and many definitions.
Meditation for me is about stilling the mind and looking within, facilitating a sense of peace and calmness
                                  Simple meditation exercise.
 The following is a simple method that I use with the aim of reducing stress, identifying tension in various parts of the body and assisting me in controlling negative thoughts and generally aiding relaxation
 Preparation for meditation
Ø Wear comfortable clothing
Ø Use a space for this purpose, a spare room or a corner of a bedroom whatever works for you importantly the space needs to be conducive to sitting quietly with an even temperature            
Ø Attempt to sit at the same time each day, this will help to establish a routine that will be easier to adhere to.
5 to 10minutes is fine to begin with. Don’t beat yourself up if you cannot achieve this.
 Sit comfortably on a chair with your back supported, feet flat on the floor [use a cushion for your feet if they don’t reach the floor] hands on your lap.
Close your eyes if this is comfortable.
Focus on your breath both the inhalation and exhalation [it is important to breathe normally not too deeply] Some people think of the word Relax as they exhale.
You will find that to begin with there are many distracting thoughts going round and round in your mind, this is normal, don’t worry about them let them come and go, just gently bring your attention back to your breath, this may be difficult to begin with but with practise it becomes easier.
It is impossible to think about 2 things simultaneously, as you focus on the breath the distracting thought will disappear at least for that moment.
You may feel fidgety at first, your body and mind need time to adjust to not worrying and rushing to do all the normal daily tasks, practise will help.
As you become more expert in the exercise you will observe which muscles are tenser than others. Gradually you will be able to sit for a longer period leaving you feeling more relaxed.  If it is preferable, quiet gentle background music could be played. Most types of meditations start with this type of exercise how long you sit and how deeply you go within yourself is a matter of personal choice
There are many articles and books re.Meditation for further research”
Anne
It will be interesting to hear the voices of dystonic patients from India for instance, where meditation is part of a long cultural tradition to know if they find it helpful.
Of course, I am not suggesting that meditation is a treatment of dystonia, or that meditation is good for everybody, but it may be a coping strategy for some dystonic patients when the stress in their life has a negative impact on the severity of their muscle spasms.

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