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.
MBSR programs have been proposed for a wide variety of conditions including stress reduction. Clinical research studies have documented various physical and mental health benefits of mindfulness in different patient categories as well as in healthy adults and children. 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 and nearly twenty years later the Center for Mindfulness in Medicine. Both these institutions supported the successful growth and implementation of MBSR into hospitals worldwide. Today close to 80% of medical schools 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." The MBSR program is an eight-week workshop that entails weekly group meetings (two-hour classes) and a one-day retreat (six-hour mindfulness practice) between sessions six and seven, formal home practice (a minimum of 45 minutes daily meditation, six days a week), 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, acceptance, and non-centering.
 Frewen, P. A., Evans, E. M., Maraj, N., Dozois, D. J. A., & Partridge, K (2008). Letting go: Mindfulness and negative automatic thinking. Cognitive Therapy and Research, 32, 758-774.
According to Kabat-Zinn, mindfulness can be considered a universal human capacity that can foster clear thinking and openheartedness, and the goal of mindfulness is to maintain awareness moment by moment, disengaging oneself from strong attachment to beliefs, thoughts, or emotions, thereby developing a greater sense of emotional balance and well-being. Engaging in mindfulness prevents one from self-criticism, ruminating about the past, or worrying about the future.
In order to become a Center for Mindfulness Certified MBSR teacher, one must complete a 7-day course at the Center. For full MBSR teacher certification, teachers must complete 6 courses through the Center within a 36-month period. 
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.
Evaluation of effectiveness
There are multiple domains where mindfulness interventions have been shown to improve outcomes. These include chronic pain, depression symptoms, anxiety, and in the treatment of drug addiction. In cancer patients, MBSR appears to bring about positive psychological outcomes, as well as favourable changes in biomarkers. Studies have also reported that MBSR training results in a smaller post-stress inflammatory response (which includes interleukin-6) and increased telomerase activity, and that MBSR may be effective for symptomatic relief in posttraumatic stress disorder. Further, MBSR may prevent or delay the onset of Alzheimer's disease.
Implications on the brain
Effects of mindfulness on the brain has been studied using neuroimaging techniques, physiological measures and behavioral tests. Neuroimaging techniques suggest that mindfulness practices such as mindfulness meditation are associated with changes in the anterior cingulate cortex, insula, temporo-parietal junction, fronto-limbic network and default mode network structures. The default mode network of the brain has been suggested as a potential biomarker for monitoring the therapeutic benefits of meditation.
- Kabat-Zinn, J (2013). Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: Bantam Dell. ISBN 978-0-345-53972-4.
- Creswell J.D. (2016). "Mindfulness Interventions". Annual Review of Psychology. 68.
- Sharma M, Rush SE (Jul 2014). "Mindfulness-based stress reduction as a stress management intervention for healthy individuals: a systematic review". J Evid Based Complementary Altern Med. 19 (4): 271–86. doi:10.1177/2156587214543143. PMID 25053754.
- Hofmann SG, Sawyer AT, Witt AA, et al. (Apr 2010). "The effect of mindfulness based therapy on anxiety and depression: a meta-analytic review". J Cons Clin Psych. 78 (2): 169–183. doi:10.1037/a0018555. PMC . PMID 20350028.
- Ludwig DS, Kabat-Zinn J (Sep 2008). "Mindfulness in medicine". JAMA. 300 (11): 1350–52. doi:10.1001/jama.300.11.1350.
- Gotink RA, Chu P, Busschbach JJ, et al. (Apr 2015). "Standardised Mindfulness-Based Interventions in Healthcare: An Overview of Systematic Reviews and Meta-Analyses of RCTs". PLOS ONE. 10 (4): e0124344. doi:10.1371/journal.pone.0124344. PMC . PMID 25881019.
- Paulus MP. (Jan 2016). "Neural Basis of Mindfulness Interventions that Moderate the Impact of Stress on the Brain". Neuropsychopharmacology. 41 (1).
- Brown LJ (1996). "Yoga: 5,000 years young". Complementary Health Practice Review. 2 (3): 185–187. doi:10.1177/153321019600200307.
- Armstrong, A. (2004). Buddha. New York: Lipper/Penguin
- Rosenzweig D (2013). "The sisters of mindfulness". Journal of Clinical Psychology. 69 (8): 793–804. doi:10.1002/jclp.22015.
- Sharf R (1995). "Buddhist modernism and the rhetoric of meditative experience". Numen. 42 (3): 228–283. doi:10.1163/1568527952598549.
- Laura Buchholz (Oct 2015). "Exploring the Promise of Mindfulness as Medicine". JAMA. 314 (13): 1327–1329. doi:10.1001/jama.2015.7023.
- "MBSR Standards of Practice". University of Massachusetts Medical School. Retrieved 2017-01-05.
- Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review, by Ruth A. Baer, available at http://www.wisebrain.org/papers/MindfulnessPsyTx.pdf
- Querstret D, Cropley M (2013). "Assessing treatments used to reduce rumination and/or worry: A systematic review". Clinical Psychology Review. 33 (8): 996–1009. doi:10.1016/j.cpr.2013.08.004. PMID 24036088.
- 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.
- Rojas, Warren (January 8, 2014). "A Meditation on the Quiet Time Caucus". Roll Call. Retrieved April 4, 2014.
- Zeidan F, Vago DR (Jun 2016). "Mindfulness meditation-based pain relief: a mechanistic account". Ann N Y Acad Sci. 1373 (1): 114–27. doi:10.1111/nyas.13153.
- Strauss C, Cavanagh K, Oliver A, Pettman D (Apr 2014). "Mindfulness-Based Interventions for People Diagnosed with a Current Episode of an Anxiety or Depressive Disorder: A Meta-Analysis of Randomised Controlled Trials". PLoS ONE. 9 (4): e96110. doi:10.1371/journal.pone.0096110. PMC . PMID 24763812.
- Khoury B, Sharma M, Rush SE, Fournier C (Jun 2015). "Mindfulness-based stress reduction for healthy individuals: A meta-analysis". J Psychosom Res. 78 (6): 519–528. doi:10.1016/j.jpsychores.2015.03.009. PMID 25818837.
- Jain FA, Walsh RN, Eisendrath SJ, et al. (2014). "Critical Analysis of the Efficacy of Meditation Therapies for Acute and Subacute Phase Treatment of Depressive Disorders: A systematic Review". Psychosomatics. 56: 297–302. doi:10.1016/j.psym.2014.10.007.
- Chiesa A (Apr 2014). "Are mindfulness-based interventions effective for substance use disorders? A systematic review of the evidence". Subst Use Misuse. 49 (5): 492–512. doi:10.3109/10826084.2013.770027. PMID 23461667.
- Garland EL (Jan 2014). "Mindfulness training targets neurocognitive mechanisms of addiction at the attention-appraisal-emotion interface". Front Psychiatry. 4 (173). doi:10.3389/fpsyt.2013.00173.
- Black DS (Apr 2014). "Mindfulness-based interventions: an antidote to suffering in the context of substance use, misuse, and addiction". Subst Use Misuse. 49 (5): 487–91. doi:10.3109/10826084.2014.860749. PMID 24611846.
- Rouleau CR, Garland SN, Carlson LE (Jun 2015). "The impact of mindfulness-based interventions on symptom burden, positive psychological outcomes, and biomarkers in cancer patients". Cancer Management and Research. 7: 121–131. doi:10.2147/CMAR.S64165.
- Rush SE, Sharma M (Aug 2016). "Mindfulness-Based Stress Reduction as a Stress Management Intervention for Cancer Care: A Systematic Review". J Evid Based Complementary Altern Med.
- Schutte NS, Malouff JM (Apr 2014). "A meta-analytic review of the effects of mindfulness meditation on telomerase activity". Psychoneuroendocrinology. 42: 45–8. doi:10.1016/j.psyneuen.2013.12.017.
- Hilton L, Maher AR, Colaiaco B, et al. (Aug 2016). "Meditation for Posttraumatic Stress: Systematic Review and Meta-analysis". Psychol Trauma.
- Larouche E, Hudon C, Goulet S (Jan 2015). "Potential benefits of mindfulness-based interventions in mild cognitive impairment and Alzheimer's disease: An interdisciplinary perspective". Behav Brain Res. 1 (276): 199–212. doi:10.1016/j.bbr.2014.05.058.
- Tang, Yi-Yuan; Posner, Michael I. (September 5, 2012). "Special issue on mindfulness neuroscience". Social Cognitive and Affective Neuroscience. 8 (1): 1–3. doi:10.1093/scan/nss104.
- Sequeira S (Jan 2014). "Foreword to advances in meditation research: Neuroscience and clinical applications". Annals of the New York Academy of Sciences. 1307: v–vi. doi:10.1111/nyas.12305. PMID 24571183.
- Holzel BK, Lazar SW, et al. (Nov 2011). "How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective". Perspectives on Psychological Science. 6 (6): 537–559. doi:10.1177/1745691611419671. PMID 26168376.
- Simon R, Engstrom M (June 2015). "The default mode network as a biomarker for monitoring the therapeutic effects of meditation". Frontiers in Psychology. 6 (776). doi:10.3389/fpsyg.2015.00776.