Mindfulness

What is Mindfulness?

Author attribution required: Johan Larsson

A personal state to cultivate: Many will find that a brief training and experience with a mindfulness practice will bring about a unique experience of peacefulness or expanded awareness. Experienced practitioners tell us that they develop an inner poise or balance, and in improved sensitivity to the signals of their body and mind. They may acquire a sense of connection to the world, and speak of feeling that they are on a path. This sense can take the form of finding a personal meaning in each new moment. They say that it is easier to accept adversity, but with an enhanced ability to respond in a positive, assertive manner.

Promises to pursue: Credible sources, as we shall discuss, claim that mindfulness practices can improve concentration and creativity, significantly reduce anxiety, depression, and pain, enhance immune system function, and increase one's overall sense of well-being and fulfillment.

Secular approaches: There is an ample secular popular literature on mindfulness, from authors such as Jon Kabat-Zinn and Jack Kornfield that encourages the development of mindfulness and related philosophical principles. Such authors may also provide trainings or retreats for first-hand experience. Trainings may or may not involve much in the way of didactics or technical practices. Some, more likely to be called retreats, may involve little instruction, while providing many hours of meditation practice.

Mindfulness is integrated into self-help and treatment programs ranging from relaxation training and stress management to dialectical behavior therapy. Training formats range from guided recordings to extensive therapy programs.

An ancient concept: As we shall discover, mindfulness is a term used in both Eastern Buddhist spiritual philosophy and Western psychotherapeutic treatment and research. It could perhaps most succinctly be described as meta-awareness -- being aware of one's own awareness. In Buddhist thinking, mindfulness is a key element of the spiritual path and the elimination of suffering.

Traditional paths: Mindfulness as a trait to cultivate has been attributed to a variety of spiritual traditions. It is most popularly associated with Buddhist philosophy and practice. Buddhist meditation training and practice is widely available throughout the West. In many areas, there are fully developed religious institutions such as Zen centers. Vipassana training is a popular format that may be provided in a more or less secular version, or fully grounded in traditional beliefs.

A clinical tool: When a cognitive therapist helps a client become aware of dysfunctional thoughts, this is a kind of meta-awareness. This awareness enables the client to recognize these thoughts as sources of discomfort, inappropriate behavior, distraction from more effective ways of thinking, and, most importantly, something that can be changed.

The client is taught to practice recognizing these thoughts. This is a form of ongoing mindfulness. One of the most recognized reasons for specifically training clients in mindfulness is so that they can more readily recognize and change dysfunctional mental patterns. Thus, mindfulness can also be described as a clinical tool.

By cultivating a sense of security or oneness through meditation or mindfulness-influenced practices, clients can more effectively pursue and attain treatment objectives.

Proponents of mindfulness assert that practitioners are less rigid in their self concept. Clients see their prior sense of self as being more limited than that derived through mindfulness practice. This appears to allow them to become more open to change, and to awareness of their own subconscious influences. They develop a more adaptable, fluid personality. With proper guidance or therapy, these traits can result in better adaptation to change, and with less stress.

Contemporary usage of the term mindfulness can refer to theory, practice, or experience. Gerner, Siegel, and Fulton (2005) describe therapeutic mindfulness as, "a theoretical construct (mindfulness), a practice of cultivating mindfulness (such as meditation), or a psychological process (being mindful).

Describing mindfulness
The Zen of it: An old Zen saying tells us that explaining Zen with mere words is like trying to scratch your foot through your shoe. Defining mindfulness is similarly challenging. Gerner, Siegel, and Fulton (2005) state, "Ultimately, mindfulness cannot be fully captured with words, because it is a subtle, nonverbal experience."

Contemporary quotes: However, western clinicians and other contemporary proponents of mindfulness have attempted to do so. The following are quotes from these individuals: Gerner, Siegel, and Fulton (2005) offer a basic definition of mindfulness as "moment-by-moment awareness."

Jon Kabat-Zinn has said, "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." (ibid) Hanh has called it, "Keeping one's consciousness alive to the present reality" (ibid)

Nyanaponika Thera calls it, "The clear and single-minded awareness of what actually happens to us and in us at the successive moments of perception."

According to Marlatt and Kristeller, it is, "Keeping one's complete attention to the experience on a moment-to-moment basis." (ibid)

Langer, offering a more western perspective, refers to it as, "A cognitive process that employs creation of new categories, openness to new information, and awareness of more than one perspective." (ibid)

Try this Basic Zen Mindfulness Experience

Zen meditation uses focused concentration on a single thing. The following experience is a common and basic Zen style of meditation.

1. Set an alarm for ten minutes. Sit in a posture that is relaxed, yet alert. If you are on a cushion, sit on the forward half.
2. Recommended: The traditional hand position is to place the blade of your right hand against your abdomen, palm up, then place your left hand on top of your right, palm up, middle knuckles overlapping. Fingers are slightly curved. Your thumbs are almost touching, facing each other. See the picture of the Zen monk.
3. Recommended: Try this traditional posture and positioning.
   • Have your spine push your head up toward the ceiling, then relax into a supportive posture with belly and buttocks slightly protruding.
   • Head does not tilt forward (ears are parallel with shoulders), but tilts nose down slightly (chin tucked in slightly).
   • Eyes gaze downward at about 45 degrees, half open, relaxed, unfocused.
   • By placing your flat tongue on the roof of your mouth and creating a vacuum, it is easier to keep your mouth closed.
   • Make sure your posture is centered by rocking slightly from side to side in decreasing arcs until you feel that you are in a balanced position.
4. Focus your attention on your breathing. Establish a calm rhythm, like the turning of a mill wheel. At first, it helps to imagine that there is a knot in the wood of the mill wheel. The top and bottom of your breath are like the passing of the knot over the top and bottom of it's path. It is a smooth transition.
5. Notice the feeling of the air entering and leaving your nose for a few breaths.
6. Become aware of the area about one and a half thumb widths beneath your navel and about one and a half thumb widths inside you. Focus your mind on that point as you breathe.
7. Give that part of your breath permission to move with your breath in and out, following the mill wheel rhythm that you have found.
8. Count your breaths from one to ten and start over again from one.
9. As you count your breaths, allow any thoughts to pass by like clouds in the sky. Whenever you find that you were lost in your thoughts, simply let them go and resume counting from one. If you become frustrated, notice why and allow that to be a thought that passes by. There is no score in meditation.
10. When you are finished, be sure you are alert before engaging in any activities. A little stretching is a nice way to become more grounded. Notice the colors in your environment. This experience is, of course, only a very brief introduction.

Evolution of Mindfulness in Psychotherapy

Roots: According to Germer, Siegel, Fulton, (2005), "The word mindfulness is an English translation of the Pali word sati. Pali was the language of Buddhist psychology 2,500 years ago, and mindfulness is the core teaching of this tradition. Sati connotes awareness, attention, and remembering."

Buddhism includes the belief that Buddha set forth a number of concepts, beliefs, and practices with both religious and personal benefits. They were religious in the sense that they had implications for the experience and transformation of the soul in relation to the universe. They were personal in that personal benefits such as equanimity were promised.

As early as the ninth century, Tang Dynasty scholar-monk Zongmi (780-841 CE) listed among five types of meditation one or ordinary people called bonpu meditation. This was for mental and physical well-being rather than for spiritual pursuits.

Although the words of Buddha were only transmitted through oral tradition for hundreds of years, the Dhammapada is held as a record of his teachings. The opening lines include a quote that promises earthly benefits to meditation and spiritual practice:



Western adoption: Western interest in Buddhist thought and practices has occurred at various points in history as the cultures of East and West were connected through trade and travel. Because of the increasing availability of translated texts, the beat generation of the 1950's, the hippies of the 1960's, and the New Age movement of the 1970's featured figures who interpreted this material for a large audience. Asian teachers of Buddhist and other transpersonal and meditative practices arrived in the West and became popular as well.

At this time, Buddhist practitioners are a well-established minority in the West, and comprise a more substantial population in southeast Asia. Although it originated in India and spread through China and Japan, Buddhism is negligible in most areas of those countries in comparison.

Connecting with psychotherapy: Buddhism itself has been referred to as a kind of psychotherapy, because of its emphasis on practices and philosophical principles intended to relieve the mind of suffering.

The earliest known use of Buddhist principles in a modern psychotherapy is Morita therapy, an approach developed in Japan by psychiatrist Shomo Morita (1874-1938), a department chair at Jikei University's School of Medicine in Tokyo.

It involved mindfulness cultivated through phases of increasing involvement with work after an initial period of withdrawal from normal life during which the patient cultivated mindfulness and an appreciation of simplicity. Morita therapy was intended for anxiety in particular. Though Morita had training in Zen Buddhism, his approach was secular and emphasized rehabilitation.

Eastern mindfulness in Western psychotherapy: Very obvious signs of the influence of Buddhist psychology can be seen in various approaches to psychotherapy and personal development approaches, particularly beginning in the late 1960's. Themes such as holism (as in "holistic health"), the unity of body and mind (as in "body mind" approaches), illusory aspects of perception and the mind, and the value of mindfulness and related meditation practices are all evident from that period forward in various ways.

For example, Gestalt Therapy involved awareness processes and related practices intended to unify the person and free them from excessive inhibitions. One such process was to be very conscious on the process of eating from a sensory perspective. The somatic approaches that emerged place great value on body awareness of both passive and active forms. Both experiential acceptance and active expression continue to be used for therapeutic purposes.

Stress management training, as originated by physician Herbert Benson, makes extensive use of mindfulness, though this approach did not use mindfulness as a key term.

Even before this, psychoanalytic writings have used Buddhist concepts in various ways, sometimes referring to meta-awareness.

Contemporary Mindfulness in Psychotherapy

Integration and Application
Further evolution: Mindfulness is clearly identified as an; active ingredient of current approaches to psychotherapy and stress management. This has developed, in part, as a reciprocal relationship between teachers of mindfulness practices and developers of psychotherapy. Some meditation thought leaders have secularized at least some of their writings and trainings, while psychotherapy thought leaders have drawn from the practices and literature of meditation and mindfulness.

Bear (2005) states that, "Mindfulness-based approaches currently are being applied with a wide range of populations, from those with recognized mental disorders or medical conditions, to those seeking stress reduction or enhanced well-being."

Applications and alignment with cognitive behavioral theory (CBT): Mindfulness has been integrated into a variety of psychotherapeutic approaches, and applied to a broad range of psychological problems. These problems include the need to prevent relapse in depression, generalized anxiety disorder, eating disorders, pain, psychosis and chronic mental illness, borderline personality disorder, psychological disorders in children and adolescents, depression in older adults, and older adults with personality disorders. Nearly all of the abovementioned problems have at least some published empirical support and a published case study.

Depression: A number of studies are reporting excellent results for depression. The theory behind the use of mindfulness approaches to depression is that mindfulness can enhance a key goal of CBT for depression: reducing patient vulnerability to a cycle of dysphoria and self-devaluative thoughts. (Ma & Teasdale, 2004)

The authors state that the accumulated evidence indicates that is best for individuals whose depression is not primarily provoked by their current situation, saying, "MBCT is most effective in preventing relapse/recurrence that is unrelated to environmental provocation." (ibid) They feel that this is consistent with the theory of the effect of mindfulness in that it promotes, "disruption of autonomous relapse-related cognitive-affective ruminative processes reactivated by dysphoria at times of potential relapse." (ibid) In both of two studies, persons with less than three episodes of depression did not benefit from MBCT. (ibid)

Anxiety disorders: Research has uncovered an aspect of anxiety disorders that supports cognitive behavioral theory, and gives reason for incorporating mindfulness. According to Orsillo and Roemer (2005):

Individuals with anxiety disorders tend to display poor understanding of their emotions, including their motivational content. Studies have shown greater effectiveness in certain tasks (even in fire fighter trainees experiencing live-fire exercises) as a result of greater understanding of one's own emotions. People who can differentiate their emotions are more likely to be able to regulate them.

This can be part of a vicious cycle in which people with poor emotional understanding come to fear and reject emotions. The result is that the discomfort is amplified. The authors provide numerous examples supporting this contention from research, clinical experience, and additional theoretical detail. (Orsillo, & Roemer, 2005)

These individuals tend to have developed dysfunctional methods of attempting to control their intense emotions. It is these methods that create a vicious cycle in which the bad results of these sometimes frantic efforts give rise to even more anxiety. These feeds into even more frantic efforts to use inappropriate means to control emotions such as anxiety.

Borderline personality disorder: An extreme version of this cycle occurs in borderline personality disorder. A psychotherapy approach which directly targets this problem, and which utilizes mindfulness as a key tool, is dialectical behavior therapy. These dysfunctional cognitive behavioral dynamics are referred to as cognitive fusion (poor perception and separate emotional and mental states), and experiential avoidance (efforts to avoid circumstances that are associated with anxiety).

By enhancing meta-awareness or objectivity, mindfulness practices address this vicious cycle, and are a valuable component of treatment of anxiety disorders.

Life-saving lifestyle modification: An emerging area is in helping medical patients adopt wellness lifestyles such as profound dietary change known to have profound medical consequences. This kind of treatment compliance enhancement may rest, in part, on mental flexibility and dis-identification with an old, less functional concept of the self. Mindfulness practices are believed to generate that kind of personal capacity. (Yourell, R., 2009) This has been explored with cancer patients, inner city patients and others. (Bear, 2005)

Try this Basic Vipassana Mindfulness Experience:
Vipassana is a form of meditation that encourages an expansive awareness of the mind as a flow of consciousness. This experience is a typical introduction to Vipassana style of meditation. It starts with a limited focus of awareness, and expands.

1. Sit in a posture that is relaxed, yet alert.
2. As in the Zen style, focus your attention on your breathing. Establish a calm rhythm, like the turning of a mill wheel.
3. Notice the feeling of the air entering and leaving your nose for a few breaths.
4. Expand your body awareness to any feelings that come into your awareness. Simply notice this for a few breaths.
5. Shift your awareness to your hearing. Simply notice whatever sounds come into your awareness. Do this for a few breaths.
6. Shift your awareness to your thoughts. Simply notice whatever thoughts pass through your mind. Do this for a few breaths. You may notice that thoughts trigger feelings in your body that also pass through your mind.
7. Now, instead of restricting your awareness to a particular sensory channel, allow your self to notice whatever passes through your consciousness. Do this for about five minutes the first time.
8. When you are finished, be sure you are alert before engaging in any activities. A little stretching is a nice way to become more grounded. Notice the colors in your environment.

This experience is, of course, only a very brief introduction.

Mindfulness Integrative Psychotherapies
Dialectical behavior therapy: A major landmark in the integration of mindfulness into psychotherapy is Dialectical Behavior Therapy, developed by Marsha Linehan (1993). This approach was originally developed for persons with borderline personality disorder (BPD) and suicidality. At that time, approaches to BPD were not very effective, and there was great misunderstanding of BPD.

The element of mindfulness in Linehan's approach served to facilitate a variety of objectives. Linehan realized that it was very important to help persons with BPD to establish a capacity to objectively observe their emotional reactions rather than to identify with them. This allows clients to choose coping behaviors that are more effective.

A breakthrough concept in Linehan's approach was the recognition that person's with BPD were desperately trying to manage very intense and painful emotions with ineffective and impoverished coping strategies. The approach emphasizes psychoeducation, and clients meet in a group format to be acquainted with concepts such as this, and to establish more effective means of coping. A notable outcome is that by refraining from struggling with their emotions or with their environment, the emotions are not as intense, Thus, some improvement comes not from external coping measures, but from the cultivation of mindfulness as nonjudgmental or passive awareness.

Although it was a breakthrough, it was also an extension of a fundamental thread in cognitive therapy theory. From the earliest writings in the 1950's, it was recognized that dysfunctional behaviors were efforts to manage emotional distress. However, the emphasis was on restructuring thought patterns, particularly where letting go of demands associated with catastrophic thinking were concerned. The cultivation of mindfulness as a practice was not a part of cognitive therapy.

Mindfulness-Based Cognitive Therapy (MBCT) is a psychotherapy that employs mindfulness techniques with cognitive therapy. It has been applied primarily to major depressive disorder. It was developed in 2002 by a team of psychologists; Zindel Segal from Toronto, Mark Williams from Oxford, and John Teasdale from Cambridge. It includes a strong emphasis on mindfulness meditation.

Acceptance and Commitment Therapy (ACT) was developed by Steven C. Hayes and other clinicians. It is a highly cognitive approach that emphasizes behavior and attitude change.

Mindfulness-Based Stress Reduction (MBSR) was developed by Jon Kabat-Zinn at the University of Massachusetts Medical School. This approach has been the subject of encouraging research for its use with depression and anxiety disorders. Additional studies, funded by the National Center for complementary and Alternative Medicine are underway.

Anxiety Management Training (AMT): was developed for PTSD. It instructs participants to apply a collection of cognitive and behavioral skills that help them cultivate emotional responses that are more comfortable and supportive of their aims. A key modality of this method is relaxation training.

Integrative Body-Mind Training (IBMT) was developed in the 1990s in China, and is practiced by thousands of people there. (University of Oregon, 2009, May 20)

According to a researcher and proponent of IBMT:



Research on the Benefits of Mindfulness, Meditation and Relaxation Training

Western Foundational Work
Meditation and relaxation training predating "mindfulness": Various forms of relaxation training and meditation have existed for decades, and have been offered for mental and physical benefits. Broad interest in stress management and relaxation developed after Herbert Benson, a physician working with cardiology patients, coined the term "relaxation response" in 1975, and tied the functioning of the autonomic nervous system to heart health.

This insight stemmed from physiologist Walter B. Cannon's work in understanding what he termed the "fight or flight" response. Essentially, Cannon explained that our ability to respond to threats with a heightened capacity to fight or flee from danger was also a vulnerability if it was triggered too much of the time. The result of this excess was over-taxation of the body, leading to illness.

Benson's emphasis was on the role of the fight or flight response (activation of the sympathetic nervous system) in high blood pressure and heart disease. Benson's work has taken in a broad range of information, and he has many books and journal publications that show the evolution of his thinking and evidence for the importance of mind-body approaches to well-being.

Subsequent research is helping to pinpoint body-mind health connections leading to the biopsychosocial perspective that looks at not only physiology and psychology, but also the social factors affecting health. Isolation, depression, low social status, and hostility have been tied to shortened life span and poor health outcomes. While the hard-driving "type A" personality was credited with creating heart disease, the ambitiousness of the individuals was not so much a factor as hostility. This propensity for hostile feelings was not limited to people, but included circumstances, and even a battle against time as though it were the enemy. The type A style was blamed for harming the cardiovascular system through factors such as increased blood pressure. Stress and hostility, in general, are associated with heart disease and other poor health outcomes. (Esch, Stefano, Fricchione, & Benson, 2002)

Health Benefits Studied
A two way street: While meditation has held the promise of tranquility and well being for millennia, new insights into our dependence on the physiology of our nervous systems provide an opportunity to integrate burgeoning scientific insight with ancient practices so that both may evolve in light of each other's influence.

Consider the experience of Tibetan monk refugees suffering from an elevated "prevalence of serious mental health disorders within this population," including PTSD. Their capacity to meditate faltered in the face of flashbacks, sleep disorders, and other symptoms resulting from strife in their homeland and, in many cases, torture. (Mills, et al., 2005)

They required therapy to regain their capacity to fully participate in their cultural meditative traditions. In Boston, this took the form of Eastern and Western therapies, combined in a culturally sensitive manner by The Boston Center for Refugee Health and Human Rights (BCRHHR) at Boston Medical Center. Treatment included Tibetan practices such as chi gong and singing bowl meditation, and Western aids such as antidepressant medication and psychotherapy. (Boston University, 2009)

This experience appears to highlight the physiological aspect of mental health, in that monks are vulnerable to post traumatic stress disorder despite their extensive experience with meditation and mystical practices. With the history of dramatic claims for meditation, some may find this surprising.

Limited support from high-quality research for improvement in medical conditions: Promises of improvements in medical conditions are not well-grounded. According to recent meta-studies, the higher-quality research on meditation, relaxation training, and mindfulness has not generally shown strong health benefits for medical patients, except where quality of life is concerned. However, research on these modalities has generally been of limited quality, until recently. There are numerous studies that show improvements in medical conditions, but they have not met the challenge posed by meta-studies of "gold standard" research. When the best studies show the poorest outcomes, there is cause for concern. However, the low number of high-quality studies leaves open the prospect for a more optimistic view in time.

Challenging issues: Given that mindfulness-related training and practice is most likely to be integrated into multimodal programs for health, and given that elements of mindfulness training occur in modalities such as lifestyle intervention and CBT, researchers have significant challenges in attempting to isolate these modalities as truly independent variables.



Surprising gaps: Relaxation training, famously championed by Dr. Herbert Benson for treatment and prevention of cardiac conditions, particularly high blood pressure, (and with a long history of scrutiny and application) has not met the challenge posed by meta-studies of gold-standard research. (Dickinson, et al. 2008)



Even CBT is not showing strong results in affecting cardiac patients (a population that would be expected to respond), according to a meta-study. (Linden, Phillips, & Leclerc, 2007) In the case of CBT, there were improvements noted, but they were not long term, and only occurred for men.

Meta-Studies: Meta-studies on meditation including one commissioned by United States National Center for Complementary and Alternative Medicine state that firm conclusions cannot be drawn regarding clinical claims about effects of meditation. (Ospina, et al. 2007) The authors of that meta-study state:



However, there are areas in which research of good quality is appearing. The Journal of Alternative and Complementary Medicine published a meta-study of the health benefits of various "meditative practices" for medical illnesses. (Arias, Steinberg, Banga, & Trestman, 2006) The reviewers found 82 moderate to high quality studies, from which 20 randomized controlled trials were reviewed.

Although the authors stated that, "Clear and reproducible evidence supporting efficacy from large, methodologically sound studies is lacking." they concluded that, "The strongest evidence for efficacy was found for epilepsy, symptoms of the premenstrual syndrome and menopausal symptoms. Benefit was also demonstrated for mood and anxiety disorders, autoimmune illness, and emotional disturbance in neoplastic disease." (ibid)

The practices studied did not produce bad outcomes in any of the 958 subjects in the studies. "No serious adverse events were reported in any of the included or excluded clinical trials."(ibid)

Canter summarizes the situation as of 2003 as follows:



Criticism of existing research: Benefits claimed for meditation have been criticized on several fronts. (Canter, 2003) These include:



Design factors that tend to bias results in favor of stress management and meditation modalities include failing to control for the attention that subjects get, and failing to get adequate baseline measurement. (Rainforth, Schneider, Nidich, Gaylord-King, Salerno, & Anderson, 2007)

However, increasingly sophisticated studies are beginning to appear, so this situation may change. The most likely area where meditation will prove to have health implications is with illnesses that are highly sensitive to stress.

Emerging, promising evidence: Although observations of the effect of meditation on specific physiological measurements has been encouraging, such measurements do not constitute proof of improvements in longevity or functioning. However, the authors of a study supported by postdoctoral research fellowship from the National Institute of Mental Health state, "There is emerging evidence from (their own and) other studies that shows that behavioral stress-management programs can buffer HIV declines in HIV-positive people." (UCLA, 2008, July 27) Their study found a health-protective effect, particularly for HIV positive subjects experiencing higher levels of stress. More specifically, the study found, "no loss of CD4 T cells... In contrast, the control group showed significant declines in CD4 T cells from pre-study to post-study." (ibid)

Longer programs needed? In recognizing the dose-response relationship, and the significant differences in highly experienced meditators, researchers are beginning to look at longer term use of meditation and relaxation training. For example, a blinded, randomized controlled study of individuals with a type of hypertension most common in elderly persons used a 20 week program of relaxation training. This produced improved outcomes exceeding those of the control group. (Massachusetts General Hospital, 2008, March 29) Both groups received lifestyle counseling and showed significant improvement. All subjects had high blood pressure that was not responding well to medication. (ibid) The research was conducted at the Massachusetts General Hospital Hypertension Program and the Benson-Henry Institute for Mind-Body Medicine there, where Herbert Benson, MD, is the director emeritus.

The stress connection: Researchers are optimistic about the role of mindfulness in improving our reaction to stressors and the likely health benefits. Researchers from the University of Oregon stated that integrative body-mind training (IBMT) practiced in China resulted in less stress. They have observed lower levels of stress hormone cortisol in students taking a math test who were participants in IBMT. They also had less anxiety, depression, anger, and fatigue, even compared to students using relaxation. (University of Oregon, 2009, May 20)

Helping subjective distress and coping: The discomfort of medical conditions is also a target of mindfulness-integrative approaches. Researchers are exploring the potential value of this work in alleviating the suffering of cancer, pain, and insomnia patients. (Orsillo, & Roemer, 2005) Metastudies on CBT with mindfulness for these populations have shown better coping, psychological functioning and less stress. (ibid)

Psychological Benefits Studied
Promising in several areas: In contrast to the research on health effects of meditation and relaxation, psychological benefits are more evident. After reviewing the most recent ten years' of relevant studies, Manzoni, Pagnini, Castelnuovo, and Molinari (2008) state, "Many studies support a good efficacy of relaxation trainings in reducing anxiety. "

Standalone: Nonetheless, the authors feel there is sufficient evidence to say that, "Meditation is effective against anxiety, both if considered as a single treatment or inserted into a cognitive therapy." (ibid) They also found that meditation was helpful whether provided in individual or group settings, and that there was a dose-response relationship, that is, that more is better, at least up to a point.

Strongest methods, participants with best results: In addition to meditation, the relaxation methods that showed the greatest efficacy were progressive relaxation, applied relaxation, and autogenic training. The populations that had the greatest benefit were younger participants and those with psychosomatic and psychological problems, and those instructed to practice at home, the latter factor being in keeping with the positive dose-response correlation. Combinations of relaxation techniques showed poorer results than single methods. (ibid)

Relaxation is not mindfulness: To help distinguish between relaxation training and mindfulness as an aspect of treatment, the authors state that:

Meditation is sometimes considered to be a form of relaxation therapy, however meditation not only creates a relaxation response but also produces an altered state of consciousness which facilitates the meta-cognitive mode of thinking which make possible the expectation of cognitive-behavioral benefits. (ibid)



Try this Focusing Experience:
Emerging Neurological and Genomic Evidence

Try this Compassion Meditation
This is a variation on compassion, moderately re-engineered by the author based on modern Western sensibilities.

Take time to fully experience each step.

1. To stay attentive, the ideal posture is to sit in a comfortable, upright position.
2. Relax. A nice way to do this is to imagine warm cosmic butter on top of your head. Allow it to melt, relaxing each area of your body from your head down. Allow it to relax your insides as you absorb its gentle energy.
3. Allow that energy to carry your awareness to your heart. Allow yourself to accept whatever feelings are there.
4. Imagine your feelings as a pool of water. Generate some loving thoughts about yourself, and imagine that they are flower petals. Drop each flower petal into that pool. For example, "This honors you...this carries good will to you...this touches the perfection in you." Observe and sense the ripples moving out from each petal falling to the pool."
5. Bring to mind someone you know, and who is experiencing some suffering. This first time, choose someone whose feelings are not overwhelming.
6. Imagine that they are experiencing the radiance of your goodwill, and finding this relaxing.
7. Imagine sending them thoughts that are pillows of gentle energy. "This honors you...this carries good will to you...this touches the perfection in you."
8. Imagine this energy converting their suffering into life-giving energy.
9. Think of someone who you feel is misguided. This process will not ask you to forgive or to protect this person from the consequences of their behavior. Rather, this is an opportunity for you to engender compassion within yourself in order to be objective and personally powerful.
10. Imagine that they are experiencing the radiance of your goodwill, and finding this relaxing.
11. Imagine sending them thoughts that are pillows of gentle energy. "This honors you...this carries good will to you...this touches the perfection in you."
12. Imagine this energy converting their suffering into life-giving energy.(Think of a color that represents that, and imbue the energies with that color.)
13. Imagine that energy gently strengthening the limitations that lead them to make poor choices. (Think of a color that represents that, and imbue the energies with that color.)
14. Imagine insight that will liberate them from their negative patterns building up in the energies around them, becoming available to them when they are ready to gain more insight. (Think of a color that represents that, and imbue the energies with that color.)
15. Imagine all these energies expanding to envelope the earth and all beings.
16. Sense yourself within that immense continuum, breathing and absorbing the energies of life and compassion.
17. Imagine that a color that is the ideal energy for you right now brings you balance and readiness for your own fresh insights.
18. Take your time to savor this experience. Allow any thoughts that arise to pass by, like clouds in the sky.
19. Do whatever you feel will complete this experience for now, knowing that you will carry it with you to continue its healing work during your other activities.
20. As you return to normal consciousness, make sure you are alert before engaging in any activities. Be aware of the colors in your environment and the surface you are on.

Citations

Baer, R. A., (ed.) (2005). Mindfulness-Based Treatment Approaches: Clinician's Guide to Evidence Base and Applications (1st ed.). Academic Press.

Boston University (2009, March 13). Researchers Discover Ways Of Integrating Treatment Of Traumatized Tibetan Refugee Monks. ScienceDaily. Retrieved July 2, 2009, from http://www.sciencedaily.com? /releases/2009/03/090313080100.htm

Canter, P. H. (2003). The therapeutic effects of meditation: The conditions treated are stress related, and the evidence is weak. BMJ : British Medical Journal, 326(7398), 1049-1050. doi: 10.1136/bmj.326.7398.1049.

Dickinson, H. O., Campbell, F., Beyer, F. R., Nicolson, D. J., Cook, J. V., Ford, G. A., & Mason, J. M. (2008). Relaxation therapies for the management of primary hypertension in adults: a Cochrane review. Journal of human hypertension. 01/07/2008. DOI: 10.1038/jhh.2008.65.

Epstein, M. (2007). Psychotherapy without the self. Yale University Press.

Esch, T., Stefano, G. B., Fricchione, G. L., Benson, H. (2002). Stress in cardiovascular diseases. Medical Science Monitor, 8(5):RA93-RA101.

Gendlin, E. T. (1983). Focusing. Bantam Books.

Germer, C. K., Siegel, R. D. (2005). Mindfulness and Psychotherapy. The Guilford Press.

Krisanaprakornkit T, Krisanaprakornkit W, Piyavhatkul N, Laopaiboon M. Meditation therapy for anxiety disorders. Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD004998. DOI: 10.1002/14651858.CD004998.pub2

Lazar S. W., Kerr C. E., Wasserman R. H., Gray J. R., Greve D. N., et al. (2005). Meditation experience is associated with increased cortical thickness. Neuroreport, 16(17):1893-7.

Linden, W., Phillips, M. & Leclerc, M. J. (2007). Psychological Treatment of Cardiac Patients: A Meta-Analysis. European Heart Journal, 28(24):2972-2984.

Linehan, Marsha M. (1993a). Cognitive-behavioral treatment of borderline personality disorder. NY: Guilford Press. ISBN 0-89862-183-6.

Linehan, Marsha M. (1993b). Skills training manual for treating borderline personality disorder. NY: Guilford Press. ISBN 0-89862-034-1.

Luoma, J. B., Hayes, S. C., & Walser, R. D. P. (2007). Learning Act: An Acceptance & Commitment Therapy Skills-Training Manual for Therapists. New Harbinger Publications.

Ma, S.H. & Teasdale, J.D. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72, 31-40.

Manzoni, G. M., Pagnini, F., Castelnuovo, G., & Molinari, E. (2008). Relaxation training for anxiety: a ten-years systematic review with meta-analysis. BMC Psychiatry, 8(41). doi: 10.1186/1471-244X-8-41.

Massachusetts General Hospital (2008, March 29). Relaxation training may improve control of hard-to-treat systolic hypertension. ScienceDaily. Retrieved July 3, 2009, from http://www.sciencedaily.com? /releases/2008/03/080327172144.htm

Mills, E. J., Singh, S., Holtz, T. H., Chase, R. M., Dolma, S., Santa-Barbara, J., et al. (2005). Prevalence of mental disorders and torture among Tibetan refugees: A systematic review. BMC International Health and Human Rights, 5(7). doi: 10.1186/1472-698X-5-7.

Orsillo, S. M. & Roemer, L. (2005). Acceptance- and Mindfulness-Based Approaches to Anxiety: Conceptualization and Treatment (1st ed.). Springer.

Ospina, M. B., Bond T. K., Karkhaneh M., Tjosvold L., Vandermeer B., Liang, Y, et al. (2007). Meditation practices for health: state of the research. Evidence Report/Technology Assessment No. 155. (Prepared by the University of Alberta Evidence-based Practice Center under Contract No. 290-02-0023.) AHRQ Publication No. 07-E010. Rockville, MD: Agency for Healthcare Research and Quality.

Ott, M. J., Norris, R. L. & Bauer-Wu, S. M. (2006). Mindfulness meditation for oncology patients: a discussion and critical review. Integrative Cancer Therapies, 5(2):98-108.

Rainforth, M. V., Schneider, R. H., Nidich, S. I., Gaylord-King, C., Salerno, J. W. & Anderson, J. W. (2007). Stress reduction programs in patients with elevated blood pressure: A systematic review and meta-analysis. Curr Hypertens Rep, 9(6): 520-528.

Schneider RH, Staggers F, Alexander CN, Sheppard W, Rainforth M, Kondwani K, et al. A randomised controlled trial of stress reduction for hypertension in older African Americans: Hypertension, 26: 820-7.

University of California, Los Angeles (2008, July 27). Mindfulness Meditation Slows Progression Of HIV, Study Suggests. ScienceDaily. Retrieved July 2, 2009, from http://www.sciencedaily.com? /releases/2008/07/080724215644.htm

University of California - Los Angeles (2009, May 13). Meditation May Increase Gray Matter. ScienceDaily. Retrieved July 2, 2009, from http://www.sciencedaily.com? /releases/2009/05/090512134655.htm

University of Oregon (2009, May 20). Of body and mind, and deep meditation. ScienceDaily. Retrieved July 2, 2009, from http://www.sciencedaily.com? /releases/2009/05/090519104103.htm

Yourell, R. (2009). Private conversation with Gordon Saxe, MD, a physician involved in biomedical research and mindfulness integration on theimportance of mindfulness in treatment compliance, 7/4/2009.

CLOSE [X]

CLOSE [X]

CLOSE [X]