Mindfulness (psychology)

For other uses, see Mindfulness (disambiguation).

Modern clinical psychology and psychiatry since the 1970s have developed a number of therapeutic applications based on the concept of mindfulness (Pali sati or Sanskrit smriti) in Buddhist meditation.

Definitions

Bishop et al. (2004:232) regard psychological "mindfulness", broadly conceptualized, as "a kind of nonelaborative, nonjudgmental, present-centered awareness in which each thought, feeling, or sensation that arises in the attentional field is acknowledged and accepted as it is". They propose a two-component operational definition of "mindfulness".

The first component involves the self-regulation of attention so that it is maintained on immediate experience, thereby allowing for increased recognition of mental events in the present moment. The second component involves adopting a particular orientation toward one’s experiences in the present moment, an orientation that is characterized by curiosity, openness, and acceptance. (2004:232)

The former mindfulness component of self-regulated attention involves conscious awareness of one's current thoughts, feelings, and surroundings, which can result in metacognitive skills for controlling concentration. The latter mindfulness component of orientation to experience involves accepting one's mindstream, maintaining open and curious attitudes, and thinking in alternative categories (developing upon Ellen Langer's research on decision-making).

History

Although Buddhist meditation techniques originated as spiritual practices, they have a long history of secular applications. For instance, the Tang Dynasty Chan (Japanese Zen) and Huayan scholar-monk Zongmi (780-841) listed "Five Types of Meditation", the first of which is for fanfu (Japanese bompu) 凡夫 "ordinary people". Philip Kapleau explains:

Bompu Zen, being free from any philosophic or religious content, is for anybody and everybody. It is a Zen practiced purely in the belief that it can improve both physical and mental health. Since it can almost certainly have no ill effects, anyone can undertake it, whatever religious beliefs they happen to hold or if they hold none at all. Bompu Zen is bound to eliminate sickness of a psychosomatic nature and to improve the health generally. (1989:49)

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Clinical research shows Buddhist mindfulness techniques can help alleviate anxiety, stress, and depression

Teachers such as Thich Nhat Hanh brought mindfulness to the attention of Westerners. Mindfulness and other Buddhist meditation techniques receive support in the West from figures such as the scientist Jon Kabat-Zinn, the teacher Jack Kornfield, the teacher Joseph Goldstein, the psychologist Tara Brach, the writer Alan Clements, and the teacher Sharon Salzberg, who have been widely attributed with playing a significant role in integrating the healing aspects of Buddhist meditation practices with the concept of psychological awareness and healing. Psychotherapists have adapted and developed mindfulness techniques into several promising cognitive behavioral therapies.

Scientific research

Scientific research into mindfulness generally falls under the umbrella of positive psychology. Researchers in the field study the “conditions and processes that contribute to the flourishing or optimal functioning of people, groups, and institutions”. The study of mindfulness operates on the idea that by intentionally recognizing the potential of each small moment in a day, one can pursue a richer life experience that includes more novelty and less stress. Mindfulness is often used synonymously with the traditional Buddhist processes of cultivating awareness as described above, but more recently has been studied as a psychological tool capable of stress reduction and the elevation of several positive emotions or traits. In this relatively new field of western psychological mindfulness, researchers attempt to define and measure the results of mindfulness primarily through controlled, randomized studies of mindfulness intervention on various dependent variables. The participants in mindfulness interventions measure many of the outcomes of such interventions subjectively. For this reason, several mindfulness inventories or scales (a set of questions posed to a subject whose answers output the subject's aggregate answers in the form of a rating or category) have arisen. The most prominent include:

• the Attention Awareness Scale
• the Freiburg Mindfulness Inventory
• the Kentucky Inventory of Mindfulness Skills
• the Cognitive and Affective Mindfulness Scale.

Through the use of these scales - which can illuminate self-reported changes in levels of mindfulness, the measurement of other correlated inventories in fields such as subjective well-being, and the measurement of other correlated variables such as health and performance - researchers have produced studies that investigate the nature and effects of mindfulness. The research on the outcomes of mindfulness falls into two main categories: stress reduction and positive-state elevation.

Stress reduction

Human response to stressors in the environment produces emotional and physiological changes in individual human bodies in order to cope with that stress. This process most likely evolved to help us attend to immediate concerns in our environment to better our chances of survival, but in modern society, much of the stress felt is not beneficial in this way. Stress has been shown to have several negative effects on health, happiness, and overall wellbeing. (See stress (biology). One field of psychological inquiry into mindfulness is "mindfulness-based stress-reduction" or MBSR. Several studies have produced relevant findings:

• Jain and Shapiro (2007) conducted a study to show that mindfulness meditation may be specific in its ability to “reduce distractive and ruminative thoughts and behaviors”, which may provide a “unique mechanism by which mindfulness meditation reduces distress”.
• Arch (2006) found emotional regulation following focused breathing. A breathing group provided moderately positive responses to emotionally neutral visual slides, while "unfocused attention and worry" groups responded significantly more negatively to neutral slides.
• Brown (2003) found declines in mood disturbance and stress following mindfulness interventions.
• Jha (2010) found that a sufficient meditation training practice may protect against functional impairments associated with high-stress contexts.
• Garland (2009) found declines in stress after mindfulness interventions, which are potentially due to the positive re-appraisals of what were at first appraised as stressors.

Elevation of positive emotions and outcomes

While much research centered on mindfulness seeks to reduce stress, another large body of research has examined mindfulness as a tool to elevate and sustain "positive" emotional states as well and their related outcomes:

• Fredrickson (2008) studied the building of personal resources through increased daily experiences of positive emotions due to meditation. She found that meditation practice showed increases over time in purpose in live, social support, and decreased illness symptoms.
• Davidson (2003) found that mindfulness meditation increased brain and immune function in positive ways, but highlighted the need for additional research.
• Brown (2009) investigated subjective well-being and financial desire. He found that a large discrepancy between financial desires and financial reality correlated with low subjective well-being, but that the accumulation of wealth did not tend to close the gap. Mindfulness however was associated with a lower financial-desire discrepancy and thus a higher subjective well-being, so mindfulness may promote the perception of “having enough”.
• Shao (2009) used a randomized controlled study to illuminate the correlation between MBA candidates subjected to a mindfulness intervention and increased academic performance. He found mindfulness was positively related to performance for women.
• Another study showed both an increase in positive effects and a decrease in negative effects due to meditation. After a six-week training program in mindfulness meditation, participants showed "significant increases in left-sided anterior activation, a pattern previously associated with positive affect, in the meditators compared with the nonmeditators," as well as a rise in antibody titer in response to an influenza vaccine. Both of these measures indicate that mindfulness meditation develops parts of the brain associated with a decrease in anxiety and "negative" affect as well as an increase in positive affect, and immune function. The participants who had meditated were also not meditating at the time that the tests were performed.

Future directions

The research leaves many questions still unanswered. First, much of the terminology used in such research has no cohesive definition. For example, there is a lack of differentiation between "attention" and "awareness" and an interchangeable use of the two in modern descriptions. Buddhist contemplative psychology however, differentiates more clearly, as "attention" in that context signifies an ever-changing factor of consciousness, while "awareness" refers to a stable and specific state of consciousness. Western psychology needs to move towards more precise definitions, although it does not need to necessarily adopt the same definitions as Buddhism. Secondly, research will need to determine the operational concepts that get to the previously discussed conclusions from mindfulness, as currently most of the data is only correlational.

Therapeutic applications of mindfulness

Since 2006 research supports promising mindfulness-based therapies for a number of medical and psychiatric conditions, notably chronic pain (McCracken et al. 2007), stress (Grossman et al. 2004), anxiety and depression (Hofmann et al. 2010), substance abuse (Melemis 2008:141-157), and recurrent suicidal behavior (Williams et al. 2006). Bell (2009) gives a brief overview of mindful approaches to therapy, particularly family therapy, starting with a discussion of mysticism and emphasizing the value of a mindful therapist.

Morita therapy

Main article: Morita therapy

The Japanese psychiatrist Shoma Morita, who trained in Zen meditation, developed Morita therapy upon principles of mindfulness and non-attachment.

Gestalt therapy

Main article: Gestalt therapy

Since the beginnings of Gestalt therapy in the early 1940s, mindfulness, referred to as "awareness", has been an essential part of its theory and practice.

Adaptation Practice

The British psychiatrist, Clive Sherlock , who trained in the traditional Rinzai School of Zen, developed Adaptation Practice (AP) in 1978 based on the profound mindfulness/awareness training of Zen daily-life practice and meditation. Adaptation Practice is used for long-term relief of depression, anxiety, anger, stress and other emotional problems.

Mindfulness-based stress reduction

Main article: Mindfulness-based stress reduction

Jon Kabat-Zinn developed the Mindfulness-Based Stress Reduction (MBSR) over a ten-year period at the University of Massachusetts Medical School. He (1990:11) defines the essence of MBSR: "This "work" involves above all the regular, disciplined practice of moment-to-moment awareness or mindfulness, the complete "owning" of each moment of your experience, good, bad, or ugly." Kabat-Zinn explains the non-Buddhist universality of MBSR:

Although at this time mindfulness meditation is most commonly taught and practiced within the context of Buddhism, its essence is universal. … Yet it is no accident that mindfulness comes out of Buddhism, which has as its overriding concerns the relief of suffering and the dispelling of illusions. (2005:12-13)

MBSR has clinically proven beneficial for people with depression and anxiety disorders. This mindfulness-based psychotherapy is practiced as a form of complementary medicine in over 200 hospitals, and is currently the focus of numerous research studies funded by the National Center for Complementary and Alternative Medicine.

Mindfulness-based cognitive therapy

Main article: Mindfulness-based cognitive therapy

Mindfulness-based cognitive therapy (MBCT) psychotherapy combines cognitive therapy with mindfulness techniques as a treatment for major depressive disorder.

Acceptance and commitment therapy

Main article: Acceptance and commitment therapy

Steven C. Hayes and others have developed acceptance and commitment therapy (ACT), originally called "comprehensive distancing", which uses strategies of mindfulness, acceptance, and behavior change.

Dialectical behavior therapy

Main article: Dialectical behavior therapy

Mindfulness is a "core" exercise used in Dialectical behavior therapy (DBT), a psychosocial treatment Marsha M. Linehan developed for treating people with borderline personality disorder. DBT is dialectic, explains Linehan (1993:19), in the sense of "the reconciliation of opposites in a continual process of synthesis." As a practitioner of Buddhist meditation techniques, Linehan says:

This emphasis in DBT on a balance of acceptance and change owes much to my experiences in studying meditation and Eastern spirituality. The DBT tenets of observing, mindfulness, and avoidance of judgment are all derived from the study and practice of Zen meditation. (1993:20-21)

Hakomi

Main article: Hakomi

Hakomi therapy, under development by Ron Kurtz and others, is a somatic psychology based upon Asian philosophical precepts of mindfulness and nonviolence.

Internal Family Systems Therapy

Main article: Internal Family Systems Model

Internal Family Systems Therapy (IFS), developed by Richard C. Schwartz, emphasizes the importance of both therapist and client engaging in therapy from the Self, which is the IFS term for one’s "spiritual center". The Self is curious about whatever arises in one’s present experience and open and accepting toward all manifestations.

Mindfulness meditation in organizations

In the U.S., certain businesses, universities, government agencies, counseling centers, schools, hospitals, religious groups, law firms, prisons, the army, and other organizations offer training in mindfulness meditation.

In the U.S. business world, interest in mindfulness is rising dramatically. This shows in the popular business press, including books such as Awake at Work (Carroll, 2004) and Resonant Leadership: Renewing Yourself and Connecting with Others Through Mindfulness, Hope, and Compassion.

The website of the University of Massachusetts Medical School Center for Mindfulness in Medicine, Health Care, and Society and Carroll’s (2007) book, The Mindful Leader, mention many companies that have provided training programs in mindfulness. These include Fortune 500 companies (such as Raytheon, Procter & Gamble, Monsanto, General Mills, and Comcast) and others (such as BASF Bioresearch, Bose, New Balance, Unilever, and Nortel Networks). Executives who “meditate and consider such a practice beneficial to running a corporation” have included the chairman of the Ford Motor Company, Bill Ford, Jr.; a managing partner of McKinsey & Co., Michael Rennie; and Aetna International’s former chairman, Michael Stephen. A professional-development program — “Mindfulness at Monsanto” — was started at Monsanto corporation by its CEO, Robert Shapiro.

Another corporation (Sounds True, an audio recordings company) has mindfulness as a core value.

At Sounds True, we strive to practice mindfulness in every aspect of our work. Recognizing the importance of silence, inward attention, active listening and being centered, Sounds True begins its all-company meetings with a minute of silence and maintains a meditation room on-site for employees to utilize throughout the day. )

In some newspapers, magazines, and scholarly journals in fields other than management, one can find indicators of interest in mindfulness in organizations outside of business. This includes legal and law enforcement organizations.

• Harvard Law School’s Program on Negotiation hosted a workshop on “Mindfulness in the Law & Alternative Dispute Resolution.”
• Police officers in Los Angeles and in Madison, Wisconsin, have received mindfulness training. Many law firms offer mindfulness classes.

• Mindfulness has been taught in prisons, reducing hostility and mood disturbance among inmates, and improving their self esteem.

• There are over 240 mindfulness programs in hospitals and clinics throughout the U. S. Many government organizations offer mindfulness training, including the Army.

Research on mindfulness in the workplace has been conducted by McCormick and Hunter. Hunter has taught a course on mindfulness to graduate students in business at Claremont Graduate University, and McCormick has taught mindfulness in the business school of California State University Northridge. In 2000, The Inner Kids Program, a mindfulness-based program developed for children, was introduced into public and private school curricula in the greater Los Angeles area.

Learning mindfulness

Jon Kabat-Zinn characterizes mindfulness as simple but not easy. It is not necessary to become a Buddhist to benefit from its practice. But the best way is to learn from a teacher. Or as Edel Maex opined: "Nobody has learned to play the piano from a book." Mindfulness can be learned quickly but takes a lifetime of practice.

Centers

As of 2010 mindfulness techniques are widely available in the Western world. Health-care insurers sometimes refund the cost of training. Mindfulness is also taught in a derivative form such as attention or awareness training.

Mindfulness is studied and taught at institutions such as:

In the United Kingdom:

• Breathworks [1], founded in 2004, offering classes in mindfulness such as: "Living Well with Pain and Illness" and "Living Well with Stress".
• Learn Mindfulness [2], offering in person (London) and telephone/online MBSR and MBCT and mindful coaching
• Mindfulness Works Ltd. [3], offering regular MBSR/MBCT classes in London

In the US:

• Mindful Awareness Research Center (MARC)[4], founded in 2006 at UCLA, offers classes and conducts research related to mindfulness, both for enhancing general well-being and treating ADHD.
• Nashville Mindfulness Center[5], founded in 2006, offers Zen mindfulness classes in the methods of Thich Nhat Hanh.
• The Insight Center [6] , founded in 2007 in West Los Angeles, teaches mindfulness meditation to the general public and provides mindfulness psychotherapy training to health professionals
• The Santa Clara University Ignatian Center for Jesuit Education [7]
• Thomas Jefferson University Hospital Mindfulness Institute [8] offers classes for the general public and training in teaching mindfulness for clinicians and educators.
• Umass Medical Center (Center for Mindfulness in Medicine, Health Care, and Society)[9], who also offer a stress reduction course.
• The University of Pennsylvania also offers a Program for Mindfulness, directed by Dr. Michael Baime [10]

See also

• Buddhism and psychology
• Buddhism and science
• Eastern philosophy and clinical psychology
• Health applications and clinical studies of meditation

Bibliography

• Bell, L. G. (2009). "Mindful Psychotherapy". J. of Spirituality in Mental Health 11:126-144.
• Bishop, S.R., Lau, M., Shapiro, S., Carlson, L., et al. (2004). "Mindfulness: A Proposed Operational Definition", Clin Psychol Sci Prac 11:230–241.
• Brantley, Jeffrey (2007). Calming Your Anxious Mind: How Mindfulness & Compassion Can Free You from Anxiety, Fear, & Panic. 2nd ed. New Harbinger. ISBN 978-1-57224-487-0.
• Bernhard, J., Kristeller, J. and Kabat-Zinn, J. (1988). "Effectiveness of relaxation and visualization techniques as an adjunct to phototherapy and photochemotherapy of psoriasis". J. Am. Acad. Dermatol. 19:572-73.
• Germer, Christopher K., Ronald Siegel, Paul R. Fulton (2005), Mindfulness and Psychotherapy, The Guilford Press, ISBN 1-59385-139-1 ( The use of mindfulness in psychology, and the history of mindfulness )
• Grossman, P., Niemann, L., Schmidt, S., and Walach, H. (2004). "Mindfulness-based stress reduction and health benefits: A meta-analysis", Journal of Psychosomatic Research 57:35–43.
• Hofmann, S.G., Sawyer, A.T., Witt. A.A., Oh, D. (2010). "The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review" J Consult Clin Psychol 78:169-83.
• Kabat-Zinn, J. (1982). "An out-patient program in Behavioral Medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results". Gen. Hosp. Psychiatry 4:33-47.
• Kabat-Zinn, Jon (1990). Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. Dell.
• Kabat-Zinn, Jon (2005). Coming to Our Senses: Healing Ourselves and the World Through Mindfulness. Hyperion.
• Kabat-Zinn, J. and Chapman-Waldrop, A. (1988). "Compliance with an outpatient stress reduction program: rates and predictors of completion". J.Behav. Med. 11:333-352.
• Kabat-Zinn, J. Chapman, A, and Salmon, P. (1997). "The relationship of cognitive and somatic components of anxiety to patient preference for alternative relaxation techniques". Mind/ Body Medicine 2:101-109.
• Kabat-Zinn, J., Lipworth, L. and Burney, R. (1985). "The clinical use of mindfulness meditation for the self-regulation of chronic pain". J. Behav. Med. 8:163-190.
• Kabat-Zinn, J., Lipworth, L., Burney, R. and Sellers, W. (1986). "Four year follow-up of a meditation-based program for the self-regulation of chronic pain: Treatment outcomes and compliance". Clin. J.Pain 2:159-173.
• Kabat-Zinn, J., Massion, A.O., Kristeller, J., Peterson, L.G., Fletcher, K., Pbert, L., Linderking, W., Santorelli, S.F. (1992). "Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders". Am. J Psychiatry 149:936-943.
• Kabat-Zinn, J., Wheeler, E., Light, T., Skillings, A., Scharf, M.S., Cropley, T. G., Hosmer, D., and Bernhard, J. (1998). "Influence of a mindfulness-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA)". Psychosomat Med 60: 625-632.
• Kapleau, Phillip (1989). The Three Pillars of Zen: Teaching, Practice and Enlightenment. Anchor Books.
• Langer, Ellen J. (1989). Mindfulness. Merloyd Lawrence.
• Linehan, Marsha (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. Guilford Press.
• Massion, A.O., Teas, J., Hebert, J.R., Wertheimer, M.D., and Kabat-Zinn, J. (1995). "Meditation, melatonin, and breast/prostate cancer: Hypothesis and preliminary data". Medical Hypotheses 44:39-46.
• McCracken, L., Gauntlett-Gilbert, J., and Vowles K.E. (2007). "The role of mindfulness in a contextual cognitive-behavioral analysis of chronic pain-related suffering and disability", Pain 131.1:63-69.
• Melemis, Steven M. (2008). Make Room for Happiness: 12 Ways to Improve Your Life by Letting Go of Tension. Better Health, Self-Esteem and Relationships. Modern Therapies. ISBN 978-1-897572-17-7
• Miller, J., Fletcher, K. and Kabat-Zinn, J. (1995). "Three-year follow-up and clinical implications of a mindfulness-based stress reduction intervention in the treatment of anxiety disorders". Gen. Hosp. Psychiatry 17:192-200.
• Nemcova, M. and Hajek, K. (2009). Introduction to Satitherapy – Mindfulness and Abhidhamma Principles in Person-Centered Integrative Psychotherapy. Morrisville, Lulu.com. ISBN 978-1-4092-5900-8
• Ockene, J.K., Ockene, I.S., Kabat-Zinn, J., Greene, H.L., and Frid, D. (1990). "Teaching risk-factor counseling skills to medical students, house staff, and fellows". Am. J. Prevent. Med. 6.2:35-42.
• Ockene, J., Sorensen, G., Kabat-Zinn, J., Ockene, I.S., and Donnelly, G. (1988). "Benefits and costs of lifestyle change to reduce risk of chronic disease". Preventive Medicine, 17:224-234.
• Saxe, G., Hebert, J., Carmody, J., Kabat-Zinn, J., Rosenzweig, P., Jarzobski, D., Reed, G., and Blute, R. (2001). "Can Diet, in conjunction with Stress Reduction, Affect the Rate of Increase in Prostate-specific Antigen after Biochemical Recurrence of Prostate Cancer?" J. of Urology 166.6:2202-2207.
• Siegel, Daniel J. (2007). The Mindful Brain: Reflection and Attunement in the Cultivation of Well-Being. Norton. ISBN 978-0-393-70470-9.
• Williams, J.M.G., Duggan, D.S., Crane, C., and Fennell, M.J.V. (2006). "Mindfulness-Based cognitive therapy for prevention of recurrence of suicidal behavior", J Clin Psychol 62:201-210.
• Williams, Mark, John Teasdale, Zindel Segal, and Jon Kabat-Zinn (2007). The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness. Guilford Press. ISBN 978-1-59385-128-6.

External links

• Jon Kabat-Zinn on Mindfulness
• Mindfulness Videos from Kabat-Zinn and colleagues
• Video- Mindfulness Meditation Taught To Google
• MindfulnessForum.com

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