Mindfulness (psychology)

Mindfulness is moment-by-moment awareness of thoughts, feelings, bodily sensations, and surrounding environment, characterized mainly by "acceptance" - attention to thoughts and feelings without judging whether they are right or wrong. Mindfulness focuses the human brain on what is being sensed at each moment, instead of on its normal rumination on the past or on the future.

Although it has roots in Buddhist meditation and mindfulness practices, a secular practice of mindfulness has entered the mainstream, in part through the work of Jon Kabat-Zinn and his Mindfulness-Based Stress Reduction (MBSR) program, launched at the University of Massachusetts Medical School in 1979. Since that time, clinical studies have documented the physical and mental health benefits of mindfulness in general, and MBSR in particular. Programs based on MBSR and similar models have been widely adapted in schools, prisons, hospitals, veterans centers, and other environments.

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.

Definitions

Mindfulness has been variously defined as "bringing one’s complete attention to the present experience on a moment-to-moment basis", "paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally", "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".

In a paper that described a consensus among clinical psychologists on an operational and testable definition, Bishop, Lau, et al (2004) proposed a two-component model 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".

In this two-component model, self-regulated attention (the first component) "involves bringing awareness to current experience - observing and attending to the changing fields of "objects" (thoughts, feelings, sensations), from moment to moment - by regulating the focus of attention". Orientation to experience (the second component) involves maintaining an attitude of curiosity about objects experienced at each moment, and about and where how the mind wanders when it drifts from the selected focus of attention. Clients are asked to avoid trying to produce a particular state (f.e relaxation), but rather to just notice each object that arises in the stream of consciousness.

Historical development

In 1979, Jon Kabat-Zinn founded the Mindfulness-Based Stress Reduction program at the University of Massachusetts to treat the chronically ill, a program that sparked a growing interest and application of mindfulness ideas and practices in the medical world 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.

Scientific research

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. Given the low quality of the underlying data, it is however possible that this conclusion was overstated. Investigating the effects of mindfulness meditation, a systematic review commissioned by the AHRQ was published in 2014, including only high-quality trials with active controls. Compared to non-specific active controls, the authors found moderate evidence of lessened anxiety, depression and pain, as well as low evidence of lessened stress. They found no evidence that meditation programs are better than any active treatment (ie, drugs, exercise, and other behavioral therapies).

Mindfulness can improve metacognitive skills for controlling concentration.

Training in mindfulness and mindfulness-based practices, often as part of a quiet meditation session, results 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, allowing practitioners to respond to their life in new rather than habitual ways.

Mindfulness scales

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:

• the Mindful Attention Awareness Scale (MAAS);
• 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.

Future directions

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.

Reception and criticism

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.) differs in significant ways from how mindfulness was defined by the Buddha himself, and by much of Buddhist tradition. 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."

A 2013 review by Alberto Chiesa 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.

Eleanor Rosch has stated that contemporary "therapeutic systems that include mindfulness" "could as much be called wisdom-based as mindfulness-based." 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?

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."

Specific mindfulness-based therapy programs

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.

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

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. 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). ACT was recently reviewed by SAMHSA's National Registry of Evidence-Based Programs and Practices.

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. 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.

Uptake by 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 link between mindfulness practice and leadership development, in particular, was strengthened with the introduction of Scouller's Three Levels of Leadership model (Scouller, 2011). His model, which emphasizes psychological self-mastery, includes mindfulness meditation as one of its main self-development techniques.

In addition, 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.

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.”
• Many law firms offer mindfulness classes.
• Mindfulness has been taught by The Art of Living Foundation, in prisons, reducing hostility and mood disturbance among inmates, and improving their self-esteem.
• Many government organizations offer mindfulness training. Coping Strategies is an example of a program utilized by United States Armed Forces personnel.

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.

See also

• Buddhism and psychology
• Buddhism and science
• Eastern philosophy and clinical psychology
• Mindfulness (journal)
• Psychological mindedness
• Research on meditation

Bibliography

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• Segal, Z.V., Williams, J.M.G., Teasdale, J.D. (2012). Mindfulness-Based Cognitive Therapy for Depression: Second Edition. Guilford Press, ISBN 978-1-4625-0750-4
• Siegel, Daniel J. (2007). The Mindful Brain: Reflection and Attunement in the Cultivation of Well-Being. Norton. ISBN 978-0-393-70470-9.
• Siegel, R.D. (2009). The Mindfulness Solution: Everyday Practices for Everyday Problems. Guilford Press, ISBN 978-1-60623-294-1
• Williams J.M.G., Duggan D.S., Crane C., Fennell M.J.V. (2006). "Mindfulness-Based cognitive therapy for prevention of recurrence of suicidal behavior". J Clin Psychol. 62 (2): 201–210. doi:10.1002/jclp.20223. PMID 16342287.{{cite journal}}: CS1 maint: multiple names: authors list (link)
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• 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.
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External links

• Jon Kabat-Zinn on Mindfulness (Youtube link)