Eastern Approaches to Altered States of Consciousness

Eastern civilizations have traditionally placed much greater emphasis on altered states of consciousness than the civilizations of the West. Altered, higher states are crucial to the major Eastern religions. They play an important role in the practice and content of cultural activities from poetry, painting, and dance to traditional martial arts throughout much of Asia. And their existence is taken for granted, and often emphasized, in popular mythology. So it is only natural that Eastern civilizations over the centuries have paid a great deal of attention to analyzing the nature of these states and developing techniques to produce them as effectively as possible. A wide variety of approaches to altering states of consciousness have been developed and used. These include purely mental meditation procedures, ancillary physical procedures, and behavioral procedures combining mental and physical components.[1] The story of Eastern approaches to altering consciousness is much too vast and complex to be covered in a single chapter. Nevertheless if we confine ourselves to the major traditions such as Yoga, Vedanta and East-Asian Buddhism, important common understandings of altered, higher states of consciousness readily emerge. For despite their different imagery and often conflicting metaphysical interpretations, they all emphasize meditation, recognize comparable levels of mind, and describe the same basic higher states of consciousness. This chapter describes important experiences, states of consciousness, levels of consciousness, and real-world effects emphasized by these traditions, relate them to features of meditation procedures, and offer reflections from the perspective of ongoing scientific research. [1] The use of pharmaceutical approaches is also mentioned favorably in some very ancient texts. In recent millennia, however, it has generally been downplayed and portrayed negatively, and major traditions often discourage it as damaging to aspects of the nervous system responsible for the growth of higher states of consciousness

Focused attention, open monitoring and automatic self-transcending: Categories to organize meditations from Vedic, Buddhist and Chinese traditions

This paper proposes a third meditation-category—automatic self-transcending— to extend the dichotomy of focused attention and open monitoring proposed by Lutz. Automatic self-transcending includes techniques designed to transcend their own activity. This contrasts with focused attention, which keeps attention focused on an object; and open monitoring, which keeps attention involved in the monitoring process. Each category was assigned EEG bands, based on reported brain patterns during mental tasks, and meditations were categorized based on their reported EEG. Focused attention, characterized by beta/gamma activity, included meditations from Tibetan Buddhist, Buddhist, and Chinese traditions. Open Monitoring, characterized by theta activity, included meditations from Buddhist, Chinese, and Vedic traditions. Automatic self-transcending, characterized by alpha1 activity, included meditations from Vedic and Chinese traditions. Between categories, the included meditations differed in focus, subject/object relation, and procedures. These findings shed light on the common mistake of averaging meditations together to determine mechanisms or clinical effects

Going outside the system: Gödel and the “I-it” structure of experience

It has often been argued that Gödel’s first incompleteness theorem has major implications for our understanding of the human mind. Gödel himself hoped that the results of his theorem, combined with Turning’s work on computers and phenomenological analysis, would establish that the human mind contains an element totally different from a finite combinatorial mechanism. Decades of attempts to establish this by reasoning about Gödel’s theorem and Turing’s work are now widely taken to be unsuccessful. The present article, in accord with Gödel’s suggestion, adds extended phenomenological analysis to the discussion. It also focuses on the “going outside the system” step central to Gödel’s method of proof, rather than on the implications of the theorem itself. Analysis of the “I-it” intentional structure, held by phenomenology to underlie all ordinary experience, yields a simple model that (i) resolves long-standing conceptual problems associated with the “I-it”, the most basic structure of phenomenology, (ii) clarifies the “going outside” step crucial to Gödel’s method of proof, (iii) avoids conceptual problems associated with this step, (iv) identifies the step as an instance of a natural pre-mathematical operation of ordinary thought, and (v) suggests that the step itself is intrinsically non-algorithmic. Logical analysis of role of this step in Gödel’s proof then shows, independently of phenomenological considerations, that anything (human or not) that can prove Gödel’s theorem soundly by his method cannot be entirely algorithmic. Further implications for the nature of the mind are then suggested

Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials

Background: Statin therapy has been shown to reduce major vascular events and vascular mortality in a wide range of individuals, but there is uncertainty about its efficacy and safety among older people. We undertook a meta-analysis of data from all large statin trials to compare the effects of statin therapy at different ages. Methods: In this meta-analysis, randomised trials of statin therapy were eligible if they aimed to recruit at least 1000 participants with a scheduled treatment duration of at least 2 years. We analysed individual participant data from 22 trials (n=134 537) and detailed summary data from one trial (n=12 705) of statin therapy versus control, plus individual participant data from five trials of more intensive versus less intensive statin therapy (n=39 612). We subdivided participants into six age groups (55 years or younger, 56–60 years, 61–65 years, 66–70 years, 71–75 years, and older than 75 years). We estimated effects on major vascular events (ie, major coronary events, strokes, and coronary revascularisations), cause-specific mortality, and cancer incidence as the rate ratio (RR) per 1·0 mmol/L reduction in LDL cholesterol. We compared proportional risk reductions in different age subgroups by use of standard χ2 tests for heterogeneity when there were two groups, or trend when there were more than two groups. Findings: 14 483 (8%) of 186 854 participants in the 28 trials were older than 75 years at randomisation, and the median follow-up duration was 4·9 years. Overall, statin therapy or a more intensive statin regimen produced a 21% (RR 0·79, 95% CI 0·77–0·81) proportional reduction in major vascular events per 1·0 mmol/L reduction in LDL cholesterol. We observed a significant reduction in major vascular events in all age groups. Although proportional reductions in major vascular events diminished slightly with age, this trend was not statistically significant (ptrend=0·06). Overall, statin or more intensive therapy yielded a 24% (RR 0·76, 95% CI 0·73–0·79) proportional reduction in major coronary events per 1·0 mmol/L reduction in LDL cholesterol, and with increasing age, we observed a trend towards smaller proportional risk reductions in major coronary events (ptrend=0·009). We observed a 25% (RR 0·75, 95% CI 0·73–0·78) proportional reduction in the risk of coronary revascularisation procedures with statin therapy or a more intensive statin regimen per 1·0 mmol/L lower LDL cholesterol, which did not differ significantly across age groups (ptrend=0·6). Similarly, the proportional reductions in stroke of any type (RR 0·84, 95% CI 0·80–0·89) did not differ significantly across age groups (ptrend=0·7). After exclusion of four trials which enrolled only patients with heart failure or undergoing renal dialysis (among whom statin therapy has not been shown to be effective), the trend to smaller proportional risk reductions with increasing age persisted for major coronary events (ptrend=0·01), and remained non-significant for major vascular events (ptrend=0·3). The proportional reduction in major vascular events was similar, irrespective of age, among patients with pre-existing vascular disease (ptrend=0·2), but appeared smaller among older than among younger individuals not known to have vascular disease (ptrend=0·05). We found a 12% (RR 0·88, 95% CI 0·85–0·91) proportional reduction in vascular mortality per 1·0 mmol/L reduction in LDL cholesterol, with a trend towards smaller proportional reductions with older age (ptrend=0·004), but this trend did not persist after exclusion of the heart failure or dialysis trials (ptrend=0·2). Statin therapy had no effect at any age on non-vascular mortality, cancer death, or cancer incidence. Interpretation: Statin therapy produces significant reductions in major vascular events irrespective of age, but there is less direct evidence of benefit among patients older than 75 years who do not already have evidence of occlusive vascular disease. This limitation is now being addressed by further trials. Funding: Australian National Health and Medical Research Council, National Institute for Health Research Oxford Biomedical Research Centre, UK Medical Research Council, and British Heart Foundation

SJS/TEN 2019: From science to translation.

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are potentially life-threatening, immune-mediated adverse reactions characterized by widespread erythema, epidermal necrosis, and detachment of skin and mucosa. Efforts to grow and develop functional international collaborations and a multidisciplinary interactive network focusing on SJS/TEN as an uncommon but high burden disease will be necessary to improve efforts in prevention, early diagnosis and improved acute and long-term management. SJS/TEN 2019: From Science to Translation was a 1.5-day scientific program held April 26-27, 2019, in Vancouver, Canada. The meeting successfully engaged clinicians, researchers, and patients and conducted many productive discussions on research and patient care needs

Updates in SJS/TEN: collaboration, innovation, and community

Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) is a predominantly drug-induced disease, with a mortality rate of 15–20%, that engages the expertise of multiple disciplines: dermatology, allergy, immunology, clinical pharmacology, burn surgery, ophthalmology, urogynecology, and psychiatry. SJS/TEN has an incidence of 1–5/million persons per year in the United States, with even higher rates globally. One of the challenges of SJS/TEN has been developing the research infrastructure and coordination to answer questions capable of transforming clinical care and leading to improved patient outcomes. SJS/TEN 2021, the third research meeting of its kind, was held as a virtual meeting on August 28–29, 2021. The meeting brought together 428 international scientists, in addition to a community of 140 SJS/TEN survivors and family members. The goal of the meeting was to brainstorm strategies to support the continued growth of an international SJS/TEN research network, bridging science and the community. The community workshop section of the meeting focused on eight primary themes: mental health, eye care, SJS/TEN in children, non-drug induced SJS/TEN, long-term health complications, new advances in mechanisms and basic science, managing long-term scarring, considerations for skin of color, and COVID-19 vaccines. The meeting featured several important updates and identified areas of unmet research and clinical need that will be highlighted in this white paper