Mindfulness (psychology)

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Mindfulness as a psychological concept is the focusing of attention and awareness, based on the concept of mindfulness in Buddhist meditation.[1] It has been popularised in the West by Jon Kabat-Zinn.[2] Despite its roots in Buddhism, mindfulness is often taught independently of religion.[3][4]

Clinical psychology and psychiatry since the 1970s have developed a number of therapeutic applications based on mindfulness for helping people suffering from a variety of psychological conditions.[5]

Definitions[edit]

Several definitions of mindfulness have been used in modern psychology. According to various prominent psychological definitions, Mindfulness refers to a psychological quality that involves

bringing one’s complete attention to the present experience on a moment-to-moment basis,[6]

or involves

paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally,[6]

or involves

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.[7]

Bishop, Lau, and colleagues (2004)[8] offered a two-component model of mindfulness:

The first component [of mindfulness] 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.[8]:232

In this two-component model, self-regulated attention (the first component) involves conscious awareness of one's current thoughts, feelings, and surroundings, awareness that can result in metacognitive skills for controlling concentration.[9] Orientation to experience (the second component) involves accepting one's mindstream, maintaining open and curious attitudes, and thinking in alternative categories (developing upon Ellen Langer's research on decision-making). Training in mindfulness and mindfulness-based practices, often as part of a quiet meditation session, results[citation needed] in the development of a Beginner's mind, or looking at experiences as if for the first time.

Practicing mindfulness can help people to begin to recognise their habitual patterns of mind which have developed out of awareness over time,[10] allowing practitioners to respond to their life in new rather than habitual ways.[10]

Definition: mindfulness vs. meditation[edit]

Mindfulness is defined as being attentive and aware, non-judgmentally,[11] [12] whereas meditation is engaging in a mental exercise (as concentration on one's breathing or repetition of a mantra) for spiritual or relaxation purposes. [13]

Historical development[edit]

In 1979, Jon Kabat-Zinn founded the Mindfulness-Based Stress Reduction program at the University of Massachusetts to treat the chronically ill,[14] a program that sparked a growing interest and application of mindfulness ideas and practices in the medical world[15]:230–1 for the treatment of a variety of conditions in people both healthy and unhealthy. The Mindfulness-Based Stress Reduction program uses the body scan as well as sitting meditation to manage pain. The body scan is derived from a traditional Burmese meditation practice called sweeping, from the school of U Ba Khin that S. N. Goenka taught in his ten-day Vipassana retreats starting 1976.

Much of this was inspired by teachings from the Eastern World, and particularly from the Buddhist traditions where mindfulness is one of the eight constituents of the Noble Eightfold Path taught by Siddhartha Gautama, The Buddha, who founded Buddhism almost 2,500 years ago. Although originally articulated as a part of what is known in the West as Buddhism, there is nothing inherently religious about mindfulness, and it is often taught independent of religious or cultural connotation.[16][17]

Scientific research[edit]

A 2013 meta-analysis of mindfulness-based therapies concluded that they are useful in treating a variety of psychological problems – for example in helping to reduce anxiety, depression, and stress – and that mindfulness was a "central component" of the therapies' effectiveness.[18] Given the low quality of the underlying data, it is however possible that this conclusion was overstated.[19]

Mindfulness scales[edit]

In the relatively new field of western psychological mindfulness, researchers attempt to define and measure the results of mindfulness primarily through controlled, randomised 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. Twelve such methods are detailed at Mindfulness Research Guide. Examples include:

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.

Future directions[edit]

The research leaves many questions still unanswered. 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.[20]

Clinical research[edit]

Research has found therapy based on mindfulness to be effective, particularly for reducing anxiety, depression, and stress.[18] A systematic review commissioned by the AHRQ was published in 2014, including only high-quality trials with active controls. The authors found moderate evidence of lessened anxiety, depression, and pain as well as low evidence of lessened stress, when compared to non-specific active controls. They found no evidence that meditation programs are better than any active treatment (ie, drugs, exercise, and other behavioral therapies).[21]

Reception and criticism[edit]

Various scholars have criticized how mindfulness has been defined or represented in recent western psychology publications. B. Alan Wallace has stated that an influential definition of mindfulness in the psychology literature (by Bishop et al.[8]) differs in significant ways from how mindfulness was defined by the Buddha himself, and by much of Buddhist tradition.[22] Wallace concludes that "The modern description and practice of mindfulness are certainly valuable, as thousands of people have discovered for themselves through their own practice. But this doesn’t take away from the fact that the modern understanding departs significantly from the Buddha’s own account of sati, and from those of the most authoritative commentators in the Theravada and Indian Mahayana traditions."[22]:62

A 2013 review by Alberto Chiesa[23] in the journal Mindfulness concluded that

According to authors well versed in the original Buddhist literature, from which several MBIs [Mindfulness Based Interventions] are overtly or implicitly derived, modern attempts to operationalize mindfulness have consistently failed to provide an unequivocal definition of mindfulness which takes into account the complexity of the original definitions of mindfulness.... Probably, a more in-depth dialogue between Western researchers concerned with the topic of mindfulness and Eastern and Western long-term mindfulness meditation practitioners will be needed before advances into the understanding of mindfulness within Western psychological theoretical frameworks will be achieved.[23]:265

Eleanor Rosch has stated that contemporary "therapeutic systems that include mindfulness"[24] "could as much be called wisdom-based as mindfulness-based."[25]:262 In these therapeutic approaches

Mindfulness would seem to play two roles: as a part of the therapy itself and as an umbrella justification ("empirical") for the inclusion of other aspects of wisdom that may be beyond our present cultural assumptions. Where in this is mindfulness in its original sense of the mind adhering to an object of consciousness with a clear mental focus?[25]:262

William Mikulas, in the Journal of Consciousness Studies, stated that "In Western psychology, mindfulness and concentration are often confused and confounded because, although in the last few years there has been a moderate interest in mindfulness, there has not been a corresponding interest in concentration. Hence, many mindfulness-based programs are actually cultivating both concentration and mindfulness, but all results are attributed to mindfulness."[26]:20

Specific mindfulness-based therapy programs[edit]

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.

The Japanese psychiatrist Shoma Morita, who trained in Zen meditation, developed Morita therapy upon principles of mindfulness and non-attachment. 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.[27]

The British doctor Clive Sherlock developed Adaptation Practice in 1977. Adaptation Practice is a structured programme of self-discipline.[28][29]

Mindfulness-based stress reduction includes a variety of meditation techniques including body awareness and breathing exercises.

Mindfulness-based cognitive therapy (MBCT) psychotherapy combines cognitive therapy with mindfulness techniques as a treatment for major depressive disorder and many other disorders.[30] 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.

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 meditations. (1993:20-21)

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 (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 techniques are included in a cognitive behavioral therapy called Acceptance and Commitment Therapy (ACT).[31][32] ACT was recently reviewed by SAMHSA's National Registry of Evidence-Based Programs and Practices.[33]

Mode Deactivation Therapy (MDT) is a treatment methodology that is derived from the principles of cognitive behavioral therapy and incorporates elements of Acceptance and commitment therapy, Dialectical behavior therapy, and mindfulness techniques.[34] Mindfulness techniques such as simple breathing exercises are applied to assist the client in awareness and non-judgmental acceptance of unpleasant and distressing thoughts and feelings as they occur in the present moment. Mode Deactivation Therapy was developed and is established as an effective treatment for adolescents with problem behaviors and complex trauma-related psychological problems, according to recent publications by Jack A. Apsche and Joan Swart.[35]

See also[edit]

References[edit]

  1. ^ Chiesa, Alberto; Calati, Raffaella; Serretti, Alessandro (2011). "Does mindfulness training improve cognitive abilities? A systematic review of neuropsychological findings". Clinical Psychology Review 31 (3): 449–64. doi:10.1016/j.cpr.2010.11.003. PMID 21183265. 
  2. ^ "The Stress Reduction Program, founded by Dr. Jon Kabat-Zinn in 1979..." - umassmed.edu
  3. ^ "Kabat-Zinn (2000) suggests that the practice of mindfulness may be beneficial to many people in Western society who might be unwilling to adopt Buddhist traditions or vocabulary. Thus, Western researchers and clinicians who have introduced mindfulness practice into mental health treatment programs usually teach these skills independently of the religious and cultural traditions of their origins (Kabat-Zinn, 1982;Linehan, 1993b)." - Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review by Ruth A. Baer
  4. ^ "Historically a Buddhist practice, mindfulness can be considered a universal human capacity proposed to foster clear thinking and open-heartedness. As such, this form of meditation requires no particular religious or cultural belief system." - Mindfulness in Medicine by Ludwig and Kabat-Zinn, available at jama.ama-assn.org
  5. ^ Grossman (2004).
  6. ^ a b "Mindfulness is a way of paying attention that originated in Eastern meditation practices. It has been described as “bringing one’s complete attention to the present experience on a moment-to-moment basis” (Marlatt & Kristeller, 1999, p. 68) and as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally” (Kabat-Zinn, 1994, p. 4)" - Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review, by Ruth A. Baer, available at http://www.wisebrain.org/papers/MindfulnessPsyTx.pdf
  7. ^ "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" - Bishop et al. (2004:232)
  8. ^ a b c Scott R. Bishop, Mark Lau, Shauna Shapiro, Linda Carlson, Nicole D. Anderson, James Carmody, Zindel V. Segal, Susan Abbey, Michael Speca, Drew Velting & Gerald Devins (2004). "Mindfulness: A proposed operational definition". Clinical Psychology: Science & Practice 11 (3): 230–241. doi:10.1093/clipsy.bph077. ISSN 0969-5893.  (see also this page's bibliography)
  9. ^ Teasdale, John D. (1999). "Metacognition, Mindfulness and the Modification of Mood Disorders". Psychiatric journal (PDF). Clinical Psychology and Psychotherapy. p. 10. Retrieved November 27, 2012. 
  10. ^ a b "Mindfulness and Integrative Psychotherapy". Retrieved 25 March 2012. 
  11. ^ dictionary.reference.com
  12. ^ [1]
  13. ^ merriam-webster.com
  14. ^ "The Stress Reduction Program, founded by Dr. Jon Kabat-Zinn in 1979..." - http://www.umassmed.edu/cfm/stress/index.aspx
  15. ^ "Much of the interest in the clinical applications of mindfulness has been sparked by the introduction of Mindfulness-Based Stress Reduction (MBSR), a manualized treatment program originally developed for the management of chronic pain (Kabat-Zinn, 1982; Kabat-Zinn, Lipworth, & Burney, 1985; Kabat-Zinn, Lipworth, Burney, & Sellers, 1987)." - Bishop et al, 2004, "Mindfulness: A Proposed Operational Definition"
  16. ^ "Kabat-Zinn (2000) suggests that mindfulness practice may be beneficial to many people in Western society who might be unwilling to adopt Buddhist traditions or vocabulary. Thus, Western researchers and clinicians who have introduced mindfulness practice into mental health treatment programs usually teach these skills independently of the religious and cultural traditions of their origins (Kabat-Zinn, 1982;Linehan, 1993b)." - Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review by Ruth A. Baer
  17. ^ "Historically a Buddhist practice, mindfulness can be considered a universal human capacity proposed to foster clear thinking and open-heartedness. As such, this form of meditation requires no particular religious or cultural belief system." - Mindfulness in Medicine by Ludwig and Kabat-Zinn, available at jama.ama-assn.org
  18. ^ a b Khoury, B.; Lecomte, T.; Fortin, G., et al. (August 2013). "Mindfulness-based therapy: a comprehensive meta-analysis". Clin Psychol Rev (Meta-analysis) 33 (6): 763–71. doi:10.1016/j.cpr.2013.05.005. PMID 23796855. 
  19. ^ "Mindfulness-based therapy: a comprehensive meta-analysis", Database of Abstracts of Reviews of Effects (Centre for Reviews and Dissemination), 29 November 2013 
  20. ^ a b Rapgay, Lobsang; Bystrisky, Alexander (2009). "Classical Mindfulness". Annals of the New York Academy of Sciences 1172: 148–62. doi:10.1111/j.1749-6632.2009.04405.x. PMID 19735247. 
  21. ^ Goyal, M; Singh, S; Sibinga, E. M.; Gould, N. F.; Rowland-Seymour, A; Sharma, R; Berger, Z; Sleicher, D; Maron, D. D.; Shihab, H. M.; Ranasinghe, P. D.; Linn, S; Saha, S; Bass, E. B.; Haythornthwaite, J. A. (2014). "Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis". JAMA Internal Medicine 174 (3): 357–68. doi:10.1001/jamainternmed.2013.13018. PMID 24395196.  edit
  22. ^ a b Wallace, B. Alan (2006). The attention revolution: Unlocking the power of the focused mind. Boston: Wisdom Publications. ISBN 0-86171-276-5. 
  23. ^ a b Chiesa, Alberto. "The Difficulty of Defining Mindfulness: Current Thought and Critical Issues". Mindfulness 4 (3): 255–268. doi:10.1007/s12671-012-0123-4. 
  24. ^ Rosch (2007) is discussing "the four therapeutic systems that include mindfulness training as a component. These systems are Mindfulness Based Stress Reduction (MBSR; Kabat-Zinn, 1990), Mindfulness Based Cognitive Therapy (MBCT; Segal, Williams, & Teasdale, 2002; Teasdale &Barnard, 1993), Dialectical Behavior Therapy (DBT; Linehan, 1993a,b), and Acceptance and Commitment Therapy (ACT; Hays, Strosahl, & Wilson, 1999). (See also Baer, 2006; and Hayes, Jacobson, Follette, & Dougher, 1994.) Patients are never just given minimalist mindfulness instructions (such as “Pay bare attention to what comes into your mind”) and then left to themselves—for good reason. I know of no cases where anyone has developed a meditation, or even relaxation, practice without considerable input." (p. 261)
  25. ^ a b Eleanor Rosch (2007). "More than mindfulness: When you have a tiger by the tail, let it eat you". Psychological Inquiry 18 (4): 258–264. doi:10.1080/10478400701598371. ISSN 1047-840X. 
  26. ^ William L. Mikulas (2007). "Buddhism & western psychology: fundamentals of integration". Journal of Consciousness Studies 14 (4): 4–49. ISSN 1355-8250. 
  27. ^ "Gestalt theory concepts". Retrieved 25 March 2012. 
  28. ^ adaptationpractice.org
  29. ^ Garvey, Anne (May 4, 2004). "Depressed? Go and clean the kitchen". The Guardian (London). 
  30. ^ Hofmann, SG. (2011). An Introduction to Modern CBT. Psychological Solutions to Mental Health Problems. Chichester, UK: Wiley-Blackwell. ISBN 0-470-97175-4 amazon.com.
  31. ^ Steven C. Hayes, Get Out of Your Mind and Into Your Life (2004) New Harbinger Press
  32. ^ Russ Harris, The Happiness Trap (2008)Trumpeter Books
  33. ^ available at nrepp.samhsa.gov, on 3/9/2011 (July 2010)
  34. ^ Apsche JA, DiMeo L (2010). Mode Deactivation Therapy for aggression and oppositional behavior in adolescents: An integrative methodology using ACT, DBT, and CBT. Oakland, CA: New Harbinger. ISBN 978-1608821075. 
  35. ^ Swart, Joan; Apsche, Jack A. (2014). "Family mode deactivation therapy (FMDT) mediation analysis". International Journal of Behavioral Consultation and Therapy. 

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External links[edit]