Mindfulness-based stress reduction
|Part of a series on|
Mindfulness-based stress reduction (MBSR) is a program that incorporates mindfulness to assist people with pain and a range of conditions and life issues that were initially difficult to treat in a hospital setting. Developed at the University of Massachusetts Medical Center in the 1970s by Professor Jon Kabat-Zinn, MBSR uses a combination of mindfulness meditation, body awareness, and yoga to help people become more mindful. In recent years, meditation has been the subject of controlled clinical research. This suggests it may have beneficial effects, including stress reduction, relaxation, and improvements to quality of life, but that it does not help prevent or cure disease. While MBSR has its roots in spiritual teachings, the program itself is secular.
In 1979 Kabat-Zinn founded the Mindfulness Based Stress Reduction Clinic at the University of Massachusetts Medical Center, and nearly twenty years later the Center for Mindfulness in Medicine, Health Care and Society at the University of Massachusetts Medical School. Both these institutions supported the successful growth and implementation of MBSR into hospitals worldwide. In 2015, MBSR is practiced as a complementary medicine, commonly in the field of oncology; in the same year, 2015, close to 80% of medical schools are reported to offer some element of mindfulness training and research and education centers dedicated to mindfulness have proliferated.
MBSR has been described as "a group program that focuses upon the progressive acquisition of mindful awareness, of mindfulness". The MBSR program is an eight-week workshop taught by certified trainers that entails weekly group meetings (two-hour classes) and a one-day retreat (six-hour mindfulness practice) between sessions six and seven, homework (45 minutes daily), and instruction in three formal techniques: mindfulness meditation, body scanning and simple yoga postures. Body scanning is the first prolonged formal mindfulness technique taught during the first four weeks of the workshop, and entails quietly lying on one's back and focusing one's attention on various regions of the body, starting with the toes and moving up slowly to the top of the head. MBSR is based on the following tenets: non-judging, non-striving, acceptance, letting go, beginner’s mind, patience, trust, and non-centering.
According to Kabat-Zinn, the basis of MBSR is mindfulness, which he defined as "moment-to-moment, non-judgmental awareness." During the program, participants are asked to focus on informal practice as well by incorporating mindfulness into their daily routines. Focusing on the present is thought to heighten sensitivity to the environment and one’s own reactions to it, consequently enhancing self-management and coping. It also provides an outlet from ruminating on the past or worrying about the future, breaking the cycle of these maladaptive cognitive processes.
Scientific evidence of debilitating effect of stress on human body, and its evolutionary origins were pinpointed by the ground-breaking work of Robert Sapolsky, and explored for lay-reader in the book "Why Zebras Don't Get Ulcers". Sapolsky's work consequently promotes mindfulness based techniques to better lifestyle and stress management.
Career Training in MBSR
The Center For Mindfulness Teacher Certification is the internationally recognized standard of practice for teachers of Mindfulness Based Stress Reduction. MBSR Teacher Certification acknowledges a teacher’s in-depth comprehension and skillful delivery of the MBSR curriculum, and accedes all teaching competencies meet practice standards as established by the University of Massachusetts Medical Center.
In order to achieve certification, you must complete the following requirements,
- SR-401 MBSR Fundamentals Course
- SR-402 MBSR Practice Teaching Intensive Course
- SR-403 MBSR Group Supervision
- SR-404 MBSR Individual Supervision
- A minimum of one elective
- Teaching experience: Eight (8) or more MBSR Courses
- A total of four silent retreats: two 5-day (or longer) silent retreats and two 7-day (or longer) silent retreats
- Continuing daily mindfulness meditation practice, yoga and other body-centered awareness disciplines
Extent of practice
According to a 2014 article in Time magazine, mindfulness meditation is becoming popular among people who would not normally consider meditation. The curriculum started by Kabat-Zinn at University of Massachusetts Medical Center has produced nearly 1,000 certified MBSR instructors who are in nearly every state in the US and more than 30 countries. Corporations such as General Mills have made it available to their employees or set aside rooms for meditation. Democratic Congressman Tim Ryan published a book in 2012 titled A Mindful Nation and he has helped organize regular group meditation periods on Capitol Hill.
Methods of practice
Mindfulness-based stress reduction classes and programs are offered by various facilities including hospitals, retreat centers, and various yoga facilities. Typically the programs focus on teaching,
- mind and body awareness to reduce the physiological effects of stress, pain or illness
- non-judgemental awareness in daily life
- promote serenity and clarity in each moment
- to experience more joyful life and access inner resources for healing and stress management
- progressive muscle relaxation
- mindfulness meditation
Evaluation of effectiveness
Mindfulness-based approaches have been tested for a range of health problems including anxiety disorder, mood disorder, substance abuse disorder, eating disorders, chronic pain, ADHD, insomnia, coping with medical conditions, with many populations including children, adolescents, parents, teachers, therapists, and physicians. As a major subject of increasing research interest, 52 papers were published in 2003, rising to 477 by 2012. Nearly 100 randomized controlled trials had been published by early 2014.
A 2013 statement from the American Heart Association on alternative approaches to lowering blood pressure concluded that MBSR was not recommended in clinical practice to lower blood pressure. MBSR can have a beneficial effect helping with the depression and psychological distress associated with chronic illness.
Preliminary evidence suggests efficacy of mindfulness meditation in the treatment of substance use disorders; however, further study is required. MBSR might be beneficial for people with fibromyalgia: there is no evidence of long-term benefit but low-quality evidence of a small short-term benefit.
In 2010, a meta-analysis was conducted by Hoffman and colleagues exploring the efficacy of MBSR and similarly structured programs for adults with symptoms of anxiety and depression. The meta-analysis showed that between pre and post testing there was significant medium within in-group effect sizes observed on anxiety and depression and also small to medium between-group effect sizes when comparing wait-list, treatment as usual, and active treatment (MBSR), further supporting the literature that states mindfulness-based therapies can be beneficial in treating symptoms of depression and anxiety. A broader meta-analysis conducted in 2004 by Grossman and colleagues found similar effect sizes when testing the physical and mental health outcomes following MBSR treatment.
- Buddhism and psychology
- Buddhist meditation
- Mindfulness (journal)
- Mindfulness and technology
- Pickert K (February 2014). "The art of being mindful. Finding peace in a stressed-out, digitally dependent culture may just be a matter of thinking differently". Time. 183 (4): 40–6. PMID 24640415.
- Will, Andrea; Rancea, Michaela; Monsef, Ina; Wöckel, Achim; Engert, Andreas; Skoetz, Nicole (2015-02-12). "Mindfulness-based stress reduction for women diagnosed with breast cancer". Cochrane Database of Systematic Reviews. doi:10.1002/14651858.cd011518. ISSN 1465-1858.
- Ospina MB, Bond K, Karkhaneh M, et al. (June 2007). "Meditation practices for health: state of the research". Evid Rep Technol Assess (Full Rep) (155): 35–37. PMC . PMID 17764203.
- "Meditation". Cancer Research UK. Retrieved September 27, 2017.
- Greeson, Jeffrey M.; Webber, Daniel M.; Smoski, Moria J.; Brantley, Jeffrey G.; Ekblad, Andrew G.; Suarez, Edward C.; Wolever, Ruth Quillian (2011). "Changes in spirituality partly explain health-related quality of life outcomes after Mindfulness-Based Stress Reduction". Journal of Behavioral Medicine. 34 (6): 508–18. doi:10.1007/s10865-011-9332-x. PMC . PMID 21360283.
- Laura Buchholz (Oct 2015). "Exploring the Promise of Mindfulness as Medicine". JAMA. 314 (13): 1327–1329. doi:10.1001/jama.2015.7023. PMID 26441167.
- Grossman, P; Niemann, L; Schmidt, S; Walach, H (2010). "Mindfulness-based stress reduction and health benefits: A meta-analysis". Focus on Alternative and Complementary Therapies. 8 (4): 500. doi:10.1111/j.2042-7166.2003.tb04008.x.
- Ospina MB, Bond K, Karkhaneh M, et al. (June 2007). "Meditation practices for health: state of the research". Evid Rep Technol Assess (Full Rep) (155): 1–263. PMC . PMID 17764203.
- Frewen PA, Evans EM, Maraj N, Dozois DJ, Partridge K (2008). "Letting go: Mindfulness and negative automatic thinking". Cognitive Therapy and Research. 32: 758–774. doi:10.1007/s10608-007-9142-1.
- on YouTube
- Hayes, Steven C.; Villatte, Matthieu; Levin, Michael; Hildebrandt, Mikaela (2011-01-01). "Open, Aware, and Active: Contextual Approaches as an Emerging Trend in the Behavioral and Cognitive Therapies". Annual Review of Clinical Psychology. 7 (1): 141–168. doi:10.1146/annurev-clinpsy-032210-104449. PMID 21219193.
- Sapolsky, Robert (1982). "The endocrine stress-response and social status in the wild baboon". Hormones and Behavior. 16: 279–292. doi:10.1016/0018-506X(82)90027-7 – via Elsevier.
- Sapolsky, Robert (2004). Why Zebras Don't Get Ulcer. USA: Holt paperbacks. p. 560. ISBN 978-0805073690.
- Rojas, Warren (January 8, 2014). "A Meditation on the Quiet Time Caucus". Roll Call. Retrieved April 4, 2014.
- "Mindfulness based stress reduction at El Camino Hospital, Mountain View, CA (accessed on Nov, 2017)".
- Hurley, Dan (January 14, 2014). "Breathing In vs. Spacing Out". New York Times Magazine. Retrieved April 9, 2014.
- Lazar SW, Kerr CE, Wasserman RH; et al. (November 2005). "Meditation experience is associated with increased cortical thickness". NeuroReport. 16: 1893–7. doi:10.1097/01.wnr.0000186598.66243.19. PMC . PMID 16272874.
- Krompinger J., Baime M. J. (2007). "Mindfulness training modifies subsystems of attention". Cognitive, Affective, & Behavioral Neuroscience. 7: 109–119. doi:10.3758/CABN.7.2.109.
- Brook, Robert D; Lawrence J. Appel; Melvyn Rubenfire; Gbenga Ogedegbe; John D. Bisognano; William J. Elliott; Flavio D. Fuchs; Joel W. Hughes; Daniel T. Lackland; Beth A. Staffileno; Raymond R. Townsend; Sanjay Rajagopalan (April 22, 2013). "Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure : A Scientific Statement From the American Heart Association". Hypertension. 61 (6): 1360–83. doi: . PMID 23608661.
- Bohlmeijer, Ernst; Prenger, Rilana; Taal, Erik; Cuijpers, Pim (2010). "The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: A meta-analysis". Journal of Psychosomatic Research. 68 (6): 539–44. doi:10.1016/j.jpsychores.2009.10.005. PMID 20488270.
- Zgierska A, Rabago D, Chawla N, Kushner K, Koehler R, Marlatt A (2009). "Mindfulness meditation for substance use disorders: a systematic review". Subst Abus (Systematic review). 30 (4): 266–94. doi:10.1080/08897070903250019. PMC . PMID 19904664.
- Lauche R, Cramer H, Dobos G, Langhorst J, Schmidt S (December 2013). "A systematic review and meta-analysis of mindfulness-based stress reduction for the fibromyalgia syndrome". J Psychosom Res (Systematic review). 75 (6): 500–10. doi:10.1016/j.jpsychores.2013.10.010. PMID 24290038.