Mindfulness

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Mindfulness
MeSHD064866

Mindfulness is the

Richard J. Davidson.[17][18]

healthy aging, weight management, athletic performance,[31] helping children with special needs
, and as an intervention during early pregnancy.

Clinical studies have documented both physical- and mental-health benefits of mindfulness in different patient categories as well as in healthy adults and children.

psychiatric disorders,[37][38][39] including moderate benefits to those with psychosis.[40][41][42] Studies also indicate that rumination and worry contribute to a variety of mental disorders,[43][44] and that mindfulness-based interventions can enhance trait mindfulness[45] and reduce both rumination and worry.[44][46][47] Further, the practice of mindfulness may be a preventive strategy to halt the development of mental-health problems.[48][49][50] Mindfulness practices have been said to enable individuals to respond more effectively to stressful situations by helping them strike the balance between over-identification and suppression of their emotional experiences by finding the middle point which is recognition and acceptance.[51]

Evidence suggests that engaging in mindfulness meditation may influence physical health.[52] For example, the psychological habit of repeatedly dwelling on stressful thoughts appears to intensify the physiological effects of the stressor (as a result of the continual activation of the sympathetic nervous system and the hypothalamus-pituitary-adrenal axis) with the potential to lead to physical health related clinical manifestations.[53][54][55] Studies indicate that mindfulness meditation, which brings about reductions in rumination, may alter these biological clinical pathways.[53][44][56] Further, research indicates that mindfulness may favorably influence the immune system[57] as well as inflammation,[3][58][59] which can consequently impact physical health, especially considering that inflammation has been linked to the development of several chronic health conditions.[60][61] Other studies support these findings.[56][62][63]

Critics have questioned both the commercialization and the over-marketing of mindfulness for health benefits—as well as emphasizing the need for more randomized controlled studies, for more methodological details in reported studies and for the use of larger sample-sizes.[3][need quotation to verify][36][web 3] While mindfulness-based interventions may be effective for youth,[64][65][66] research has not determined methods in which mindfulness could be introduced and delivered in schools.[67]

Practice

Mindfulness practice involves the process of developing the skill of bringing one's attention to whatever is happening in the present moment.[2][6][68]

Watching the breath, body-scan and other techniques

There are several exercises designed to develop mindfulness meditation, which may be aided by

guided meditations "to get the hang of it".[8][69][note 3] As forms of self-observation and interoception, these methods increase awareness of the body, so they are usually beneficial to people with low self-awareness or low awareness of their bodies or emotional state. However, it may provoke anxiety, panic attacks, depression, and dissociation,[70] in people who are very focused on themselves, their bodies, and their emotions.[71]

  • One method is to sit in a straight-backed chair or sit cross-legged on the floor or a cushion, close one's eyes and bring attention to either the sensations of breathing in the proximity of one's nostrils or to the movements of the abdomen when breathing in and out.[1][web 4][72] In this meditation practice, one does not try to control one's breathing, but attempts to simply be aware of one's natural breathing process/rhythm.[2] When engaged in this practice, the mind will often run off to other thoughts and associations, and if this happens, one passively notices that the mind has wandered, and in an accepting, non-judgmental way, returns to focusing on breathing.
  • In body-scan meditation the attention is directed at various areas of the body and noting body sensations that happen in the present moment.[1][2][web 5][web 6][web 7]
  • One could also focus on sounds, sensations, thoughts, feelings and actions that happen in the present.[2][68] In this regard, a famous exercise, introduced by Kabat-Zinn in his MBSR program,[web 8] is the mindful tasting of a raisin,[73] in which a raisin is being tasted and eaten mindfully.[74][note 4] By enabling reconnection with internal hunger and satiety cues, mindful eating has been suggested to be a means of maintaining healthy and conscious eating patterns.[75]
  • Other approaches include practicing yoga asanas while attending to movements and body sensations, and walking meditation.[1][2]

Timings

Meditators are recommended to start with short periods of 10 minutes or so of meditation practice per day. As one practices regularly, it becomes easier to keep the attention focused on breathing.[2][76] An old Zen saying suggests, "You should sit in meditation for 20 minutes every day — unless you're too busy. Then you should sit for an hour."

In Buddhist context; moral precepts

In a Buddhist context the keeping of

causation and other Buddhist teachings.[79][80]

Translations

Mindfulness meditation is part of Buddhist psychological traditions and the developing scholarship within empirical psychology.[6][81][82]

Sati and smṛti

The Buddhist term translated into English as "mindfulness" originates in the Pali term sati and in its Sanskrit counterpart smṛti. It is often translated as "bare attention", but in the Buddhist tradition it has a broader meaning and application, and the meaning of these terms has been the topic of extensive debate and discussion.[83]

According to Bryan Levman, "the word sati incorporates the meaning of 'memory' and 'remembrance' in much of its usage in both the

suttas and the [traditional Buddhist] commentary, and ... without the memory component, the notion of mindfulness cannot be properly understood or applied, as mindfulness requires memory for its effectiveness".[84]

According to Robert Sharf, smṛti originally meant "to remember", "to recollect", "to bear in mind", as in the Vedic tradition of remembering the sacred texts. The term sati also means "to remember". In the Satipaṭṭhāna-sutta the term sati means to remember the

dhammas such as the four foundations of mindfulness, the five faculties, the five powers, the seven awakening-factors, the noble eightfold path, and the attainment of insight.[85]
According to Rupert Gethin,

[sati] should be understood as what allows awareness of the full range and extent of dhammas; sati is an awareness of things in relation to things, and hence an awareness of their relative value. Applied to the satipaṭṭhānas, presumably what this means is that sati is what causes the practitioner of yoga to "remember" that any feeling he may experience exists in relation to a whole variety or world of feelings that may be skillful or unskillful, with faults or faultless, relatively inferior or refined, dark or pure."[86][note 5]

Sharf further notes that this has little to do with "bare attention", the popular contemporary interpretation of sati, "since it entails, among other things, the proper discrimination of the moral valence of phenomena as they arise."[86]

Georges Dreyfus has also expressed unease with the definition of mindfulness as "bare attention" or "nonelaborative, nonjudgmental, present-centered awareness", stressing that mindfulness in a Buddhist context also means "remembering", which indicates that the function of mindfulness also includes the retention of information.[87][note 6] Robert H. Sharf notes that Buddhist practice is aimed at the attainment of "correct view", not just "bare attention".[web 9][note 7] Jay L. Garfield, quoting Shantideva and other sources, stresses that mindfulness is constituted by the union of two functions, calling to mind and vigilantly retaining in mind. He demonstrates that there is a direct connection between the practice of mindfulness and the cultivation of morality—at least in the context of Buddhism, from which modern interpretations of mindfulness are stemming.[88]

Translation

The Pali-language scholar Thomas William Rhys Davids (1843–1922) first translated sati in 1881 as English mindfulness in sammā-sati "Right Mindfulness; the active, watchful mind".[89] Noting that Daniel John Gogerly (1845) initially rendered sammā-sati as "correct meditation",[90] Davids said:

sati is literally 'memory' but is used with reference to the constantly repeated phrase 'mindful and thoughtful' (sato sampajâno); and means that activity of mind and constant presence of mind which is one of the duties most frequently inculcated on the good Buddhist."[91]

Alternative translations

John D. Dunne says that the translation of sati and smṛti as mindfulness is confusing. A number of Buddhist scholars have started trying to establish "retention" as the preferred alternative.[92] Bhikkhu Bodhi also describes the meaning of sati as "memory".[web 10][note 8] The terms sati/smṛti have been translated as:

Definitions

Psychology

A.M. Hayes and G. Feldman have highlighted that mindfulness can be seen as a strategy that stands in contrast to a strategy of avoidance of emotion on the one hand and to the strategy of emotional over-engagement on the other hand.[94] Mindfulness can also be viewed as a means to develop self-knowledge and wisdom.[6]

Trait, state and practice

According to Brown, Ryan, and Creswell, definitions of mindfulness are typically selectively interpreted based on who is studying it and how it is applied. Some have viewed mindfulness as a mental state, while others have viewed it as a set of skills and techniques.[82] A distinction can also be made between the state of mindfulness and the trait of mindfulness.[95]

According to David S. Black, whereas "mindfulness" originally was associated with esoteric beliefs and religion, and "a capacity attainable only by certain people",[96] scientific researchers have translated the term into measurable terms, providing a valid operational definition of mindfulness.[97][note 9] Black mentions three possible domains:[97]

  1. A trait, a dispositional characteristic (a relatively long lasting trait),[97] a person's tendency to more frequently enter into and more easily abide in mindful states;[98]
  2. A state, an outcome (a state of awareness resulting from mindfulness training),[97] being in a state of present-moment awareness;[98]
  3. A practice (mindfulness meditation practice itself).[note 10]
Trait-like constructs

According to Brown, mindfulness is:

A quality of consciousness manifest in, but not isomorphic with, the activities through which it is enhanced."[82]

Several mindfulness measures have been developed which are based on self-reporting of trait-like constructs:[103]

  • Mindful Attention Awareness Scale (MAAS)
  • Freiburg Mindfulness Inventory (FMI)
  • Kentucky Inventory of Mindfulness Skills (KIMS)
  • Cognitive and Affective Mindfulness Scale (CAMS)
  • Mindfulness Questionnaire (MQ)
  • Revised Cognitive and Affective Mindfulness Scale (CAMS-R)
  • Philadelphia Mindfulness Scale (PHLMS)
State-like phenomenon

According to Bishop, et alia, mindfulness is, "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."[104]

  • The Toronto Mindfulness Scale (TMS) measures mindfulness as a state-like phenomenon, that is evoked and maintained by regular practice.[103]
  • The State Mindfulness Scale (SMS) is a 21-item survey with an overall state mindfulness scale, and 2 sub-scales (state mindfulness of mind, and state mindfulness of body).[105]

Mindfulness-practice

Mindfulness as a practice is described as:

  • "Mindfulness is a way of paying attention that originated in Eastern meditation practices"[106]
  • "Paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally"[1][note 1]
  • "Bringing one's complete attention to the present experience on a moment-to-moment basis"[1]

According to Steven F. Hick, mindfulness practice involves both formal and informal meditation practices, and nonmeditation-based exercises.[107] Formal mindfulness, or meditation, is the practice of sustaining attention on body, breath or sensations, or whatever arises in each moment.[107] Informal mindfulness is the application of mindful attention in everyday life.[107] Nonmeditation-based exercises are specifically used in dialectical behavior therapy and in acceptance and commitment therapy. [107]

Definitions arising in modern teaching of meditation

Since the 1970s, most books on meditation use definitions of mindfulness similar to Jon Kabat-Zinn's definition as "present moment awareness". However, recently a number of teachers of meditation have proposed quite different definitions of mindfulness. Shinzen Young says a person is mindful when they have mindful awareness, and defines that to be when "concentration power, sensory clarity, and equanimity [are] working together."[web 11] John Yates (Culadasa) defines mindfulness to be "the optimal interaction between attention and peripheral awareness", where he distinguishes attention and peripheral awareness as two distinct modes in which one may be conscious of things.[108]

Buddhism

According to American Buddhist monk Ven Bhante Vimalaramsi's book A Guide to Tranquil Wisdom Insight Meditation, the term mindfulness is often interpreted differently than what was originally formulated by the Buddha. In the context of Buddhism, he offers the following definition:

Mindfulness means to remember to observe how mind's attention moves from one thing to another. The first part of Mindfulness is to remember to watch the mind and remember to return to your object of meditation when you have wandered off. The second part of Mindfulness is to observe how mind's attention moves from one thing to another.[109]

In Buddhism, mindfulness is closely intertwined with the concept of interbeing, a philosophical concept used by Thich Nhat Hanh to highlight the interconnectedness of all things. This philosophy, rooted in Buddhist teachings such as Vipassana and Zen meditation, emphasizes awareness of the present moment and ethical living, reflecting the interconnected nature of existence.[110][111]

Other uses

The English term mindfulness already existed before it came to be used in a (western) Buddhist context. It was first recorded as myndfulness in 1530 (John Palsgrave translates French pensée), as mindfulnesse in 1561, and mindfulness in 1817. Morphologically earlier terms include mindful (first recorded in 1340), mindfully (1382), and the obsolete mindiness (c. 1200).[112]

According to the Merriam-Webster Dictionary, mindfulness may also refer to "a state of being aware".[web 12] Synonyms for this "state of being aware" are wakefulness,[113][114] attention,[web 13] alertness,[web 14] prudence,[web 14] conscientiousness,[web 14] awareness,[web 12] consciousness,[web 12] and observation.[web 12]

Models and frameworks for mindfulness practices

Two-component model

A two-component model of mindfulness based upon a consensus among clinical psychologists has been proposed as an operational and testable definition,[104] :

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.[115]

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 where and how the mind wanders when it drifts from the selected focus of attention. Clients are asked to avoid trying to produce a particular state (e.g. relaxation), but rather to just notice each object that arises in the stream of consciousness.[116]

The five-aggregate model

An ancient model of the mind, generally known as the five-aggregate model[81] enables one to understand the moment-to-moment manifestation of subjective conscious experience, and therefore can be a potentially useful theoretical resource to guide mindfulness interventions. This model is based upon the traditional buddhist description of the Skandhas.

The five aggregates are described as follows:

  1. Material form: includes both the physical body and external matter where material elements are continuously moving to and from the material body.
  2. Feelings: can be pleasant, unpleasant or neutral.
  3. Perceptions: represent being aware of attributes of an object (e.g. color, shape, etc.)
  4. Volition: represents bodily, verbal, or psychological behavior.
  5. Sensory consciousness: refers to input from the five senses (seeing, hearing, smelling, tasting or touch sensations) or a thought that happens to arise in the mind.

This model describes how sensory consciousness results in the generation of feelings, perception or volition, and how individuals' previously conditioned attitudes and past associations influence this generation. The five aggregates are described as constantly arising and ceasing in the present moment.[81]

Cultivating self-knowledge and wisdom

The practice of mindfulness can be utilized to gradually develop self-knowledge and wisdom.[6] In this regard, Buddhist teachings provide detailed instructions on how one can carry out an inquiry into the nature of the mind, and this guidance can help one to make sense of one's subjective experience. This could include understanding what the "present moment" is, how various thoughts, etc., arise following input from the senses, the conditioned nature of thoughts, and other realizations.[6] In Buddhist teachings, ultimate wisdom refers to gaining deep insight into all phenomena or "seeing things as they are."[6][web 2]

Historical development

Buddhism

Mindfulness as a modern, Western practice is founded on Zen and modern Vipassanā,[8][9][note 11] and involves the training of sati, which means "moment to moment awareness of present events", but also "remembering to be aware of something".[119]

Early Buddhism

Sati is one of the

delusion
(Pali: moha) have been overcome and abandoned, and are absent from the mind.

According to

Jhanas may have been the original core practice of the Buddha, which aided the maintenance of mindfulness.[120]

According to

Gotama Buddha as a rational technique for self-actualization and rejected a few parts of it, mainly the doctrine of rebirth, as residual superstitions.[121]

Zazen

The aim of zazen is just sitting, that is, suspending all judgmental thinking and letting words, ideas, images and thoughts pass by without getting involved in them.[122][123]

Contemporary Vipassana-meditation

In modern vipassana-meditation, as propagated by the

path to liberation.[web 2][web 15][note 13]

Vipassana is practiced in tandem with

Samatha, and also plays a central role in other Buddhist traditions.[16][124] According to the contemporary Theravada orthodoxy, Samatha is used as a preparation for Vipassanā, pacifying the mind and strengthening the concentration in order to allow the work of insight, which leads to liberation
.

Vipassanā-meditation has gained popularity in the west through the modern Buddhist vipassana movement, modeled after Theravāda Buddhism meditation practices,

ānāpāna
meditation as its primary techniques and places emphasis on the teachings of the Satipaṭṭhāna Sutta.

Anapanasati, satipaṭṭhāna, and vipassana

mindfulness; "ānāpāna" refers to inhalation and exhalation. Anapanasati means to feel the sensations caused by the movements of the breath in the body. The Anapanasati Sutta gives an exposition on this practice.[note 14]

Satipaṭṭhāna is the establishment of mindfulness in one's day-to-day life, maintaining as much as possible a calm awareness of one's body, feelings, mind, and dhammas. The practice of mindfulness supports analysis resulting in the arising of wisdom (Pali: paññā, Sanskrit: prajñā).[16]

Samprajaña, apramāda and atappa

In contemporary Theravada practice, "mindfulness" also includes samprajaña, meaning "clear comprehension" and apramāda meaning "vigilance".[web 17][note 15] All three terms are sometimes (confusingly) translated as "mindfulness", but they all have specific shades of meaning.

In a publicly available correspondence between Bhikkhu Bodhi and B. Alan Wallace, Bodhi has described Ven. Nyanaponika Thera's views on "right mindfulness" and sampajañña as follows:

He held that in the proper practice of right mindfulness, sati has to be integrated with sampajañña, clear comprehension, and it is only when these two work together that right mindfulness can fulfill its intended purpose.[125][note 16]

Monitoring mental processes

According to Buddhadasa, the aim of mindfulness is to stop the arising of disturbing thoughts and emotions, which arise from sense-contact.[126]

According to Grzegorz Polak, the four upassanā (foundations of mindfulness) have been misunderstood by the developing Buddhist tradition, including Theravada, to refer to four different foundations. According to Polak, the four upassanā do not refer to four different foundations, but to the awareness of four different aspects of raising mindfulness:[127]

  • the
    six sense-bases
    which one needs to be aware of (kāyānupassanā);
  • contemplation on vedanās, which arise with the contact between the senses and their objects (vedanānupassanā);
  • the altered states of mind to which this practice leads (cittānupassanā);
  • the development from the
    seven factors of enlightenment
    (dhammānupassanā).

Stoicism

The Greek philosophical school of Stoicism founded by Zeno of Citium included practices resembling those of mindfulness, such as visualization exercises. In his Discourses, Stoic philosopher Epictetus addresses in particular the concept of attention (prosoche), an idea also found in Seneca and Marcus Aurelius.[128] By cultivating it over time, this skill would prevent the practitioner of becoming unattentive and moved by instinct rather than according to reason.[129]

Christianity

Mindfulness traditions are also found in some Christian spiritual traditions. In his Rules for Eating, St. Ignatius of Loyola teaches, "let him guard against all his soul being intent on what he is eating, and in eating let him not go hurriedly, through appetite, but be master of himself, as well in the manner of eating as in the quantity which he eats."[130] He might have been inspired by Epictetus' Enchiridion.[128]

Transcendentalism

Mindfulness practitioner Jon Kabat-Zinn refers to Thoreau as a predecessor of the interest in mindfulness, together with other eminent Transcendentalists such as Emerson and Whitman:[web 18]

The collective experience[note 17] of sages, yogis, and Zen masters offers a view of the world which is complementary to the predominantly reductionist and materialistic one currently dominating Western thought and institutions. But this view is neither particularly "Eastern" nor mystical. Thoreau saw the same problem with our ordinary mind state in New England in 1846 and wrote with great passion about its unfortunate consequences.[web 18]

The forms of Asian religion and spirituality which were introduced in the west were themselves influenced by Transcendentalism and other 19th-century manifestations of

D.T. Suzuki, who attempted to present a modern interpretation of Zen, adjusted to western tastes.[117][117]

Jon Kabat-Zinn and MBSR

In 1979, Jon Kabat-Zinn founded the Mindfulness-Based Stress Reduction (MBSR) program at the University of Massachusetts to treat the chronically ill.[web 20] This program sparked the application of mindfulness ideas and practices in Medicine[136] for the treatment of a variety of conditions in both healthy and unhealthy people. MBSR and similar programs are now widely applied in schools, prisons, hospitals, veterans centers, and other environments.

Mindfulness practices were inspired mainly by teachings from the

Vipassana retreats, which he began in 1976. The body scan method has since been widely adapted to secular settings, independent of religious or cultural contexts.[note 18][note 19]

Kabat-Zinn was also influenced by the book The Varieties of Religious Experience by William James[137] which suggests that religions point toward the same experience, and which 1960s counterculture figures interpreted as meaning that the same universal, experiential truth could be reached in different ways, including via non-religious activities.[web 21]

Popularization, "mindfulness movement"

Mindfulness is gaining a growing popularity as a practice in daily life, apart from Buddhist insight meditation and its application in clinical psychology.

which?] criticisms arising.[138]

The latest changes when people moved from real-life meditation sessions to the applications on their smart devices has been even more accelerated by the global pandemic. Modern applications like are adapting to the needs of their users by using AI technology, involving professional psychologists and offering many different mindfulness approaches to serve a wider audience.[web 25]

Applications

According to Jon Kabat-Zinn the practice of mindfulness may be beneficial to many people in Western society who might be unwilling to adopt Buddhist traditions or vocabulary.[139] 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.[1] Programs based on MBSR and similar models have been widely adopted in schools, prisons, hospitals, veterans centers, and other environments.[140]

Therapy programs

Mindfulness-based stress reduction

Mindfulness-based stress reduction (MBSR) is a mindfulness-based program[web 26] developed by Jon Kabat-Zinn at the University of Massachusetts Medical Center, which uses a combination of mindfulness meditation, body awareness, and yoga to help people become more mindful.[2] While MBSR has its roots in spiritual teachings, the program itself is secular.[2]

Mindfulness-based cognitive therapy

Mindfulness-based cognitive therapy (MBCT) is a

psychological therapy designed to aid in preventing the relapse of depression, specifically in individuals with Major depressive disorder (MDD).[141] It uses traditional cognitive behavioral therapy (CBT) methods and adds in newer psychological strategies such as mindfulness and mindfulness meditation. Cognitive methods can include educating the participant about depression.[142] Mindfulness and mindfulness meditation focus on becoming aware of all incoming thoughts and feelings and accepting them, but not attaching or reacting to them.[143]

Like CBT, MBCT functions on the theory that when individuals who have historically had depression become distressed, they return to automatic cognitive processes that can trigger a depressive episode.[144] The goal of MBCT is to interrupt these automatic processes and teach the participants to focus less on reacting to incoming stimuli, and instead accepting and observing them without judgment.[144] This mindfulness practice allows the participant to notice when automatic processes are occurring and to alter their reaction to be more of a reflection. Research supports the effects of MBCT in people who have been depressed three or more times and demonstrates reduced relapse rates by 50%.[145]

Mindfulness-based pain management

Mindfulness-based pain management (MBPM) is a mindfulness-based intervention (MBI) providing specific applications for people living with chronic pain and illness.[web 27][146] Adapting the core concepts and practices of mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT), MBPM includes a distinctive emphasis on the practice of 'loving-kindness', and has been seen as sensitive to concerns about removing mindfulness teaching from its original ethical framework.[146][147] It was developed by Vidyamala Burch and is delivered through the programs of Breathworks.[web 27][146] It has been subject to a range of clinical studies demonstrating its effectiveness.[146][148][149][150][151][152][153][154]

Acceptance and commitment therapy

Acceptance and commitment therapy or (ACT) (typically pronounced as the word "act") is a form of

psychological flexibility. The approach was originally called comprehensive distancing.[157] It was developed in the late 1980s[158] by Steven C. Hayes, Kelly G. Wilson, and Kirk Strosahl.[159]

Dialectical behavior therapy

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, says Linehan,[160] 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.[161]

Mode deactivation therapy

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.[162] 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.[163]

Other programs

Morita therapy

The Japanese psychiatrist Shoma Morita, who trained in Zen meditation, developed Morita therapy upon principles of mindfulness and non-attachment.[164]

IFS

Internal Family Systems Model (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.[165]

Mindfulness relaxation

Mindfulness relaxation uses

stress.[166]

Schools

In 2012 Congressman Tim Ryan of Ohio published A Mindful Nation, and received a $1 million federal grant to teach mindfulness in schools in his home district.[76]

Mindful Kids Miami is a tax-exempt,

Miami-Dade County public and private schools. This is primarily accomplished by training educators and other childcare providers to incorporate mindfulness practices in the children's daily activities.[167]

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.[168]

MindUP, a classroom-based program spearheaded by Goldie Hawn's Hawn Foundation, teaches students to self-regulate behavior and mindfully engage in focused concentration required for academic success. For the last decade, MindUP has trained teachers in over 1,000 schools in cities from Arizona to Washington.[169]

The Holistic Life Foundation, a non-profit organization that created an in-school mindfulness program called Mindful Moment, is currently serving almost 350 students daily at Robert W. Coleman Elementary School and approximately 1300 students at

Patterson Park High School in Baltimore, Maryland. At Patterson High School, the Mindful Moment program engages the school's faculty along with the students during a 15-minute mindfulness practice at the beginning and end of each school day.[170]

Mindful Life Project, a non-profit 501(c)3 based out of Richmond, California, teaches mindfulness to elementary school students in underserved schools in the South Richmond school district. Utilizing curriculum, "Rise-Up" is a regular school day intervention program serving 430 students weekly, while "Mindful Community" is currently implemented at six South Richmond partner schools. These in-school mindfulness programs have been endorsed by Richmond Mayor Gayle McLaughlin, who has recommended additional funding to expand the program in order to serve all Richmond youth.[citation needed]

Education

Mindfulness practices are becoming more common within educational institutions including

Elementary and Secondary schools. This has been referred to as part of a 'contemplative turn' in education that has emerged since the turn of the millennium.[171] The applications of mindfulness in schools are aimed at calming and relaxation of students as well as for students and educators to build compassion and empathy for others.[172] An additional benefit to Mindfulness in education is for the practice to reduce anxiety and stress in students.[173] Based on a broad meta-analytical review, scholars said that the application of mindfulness practice enhances the goals of education in the 21st century, which include adapting to a rapidly changing world and being a caring and committed citizen. Within educational systems, the application of mindfulness practices shows an improvement of students' attention and focus, emotional regulation, creativity, and problem solving skills.[174] As discussed by Ergas and Todd, the development of this field since the turn of the millennium has brought diverse possibilities as well as complexities, given the origins of mindfulness within Buddhism and the processes of its secularization and measurement based on science.[140]

Renshaw and Cook state, "As scientific interest in the utility of Mindfulness-Based Intervention (MBI) in schools grew steadily, popular interest in mindfulness in schools seemed to grow exponentially".[175] Despite research on mindfulness being comparatively unexamined, especially with young students, the practice has seen a spike in use within the educational arena. "A relatively recent addition to discourse around preventing school expulsion and failure, mindfulness is gaining popularity for its potential to improve students' social, emotional, behavioral, and learning-related cognitive control, thereby improving academic outcomes".[176] Researchers and educators are interested in how mindfulness can provide optimal conditions for a students' personal development and academic success. Current research on mindfulness in education is limited but can provide insight into the potential benefits for students, and areas of improvement for future studies.[34][177]

Mindfulness in the classroom is being touted as a promising new intervention tool for young students. According to Choudhury and Moses, "Although still marginal and in some cases controversial, secular programs of mindfulness have been implemented with ambitious goals of improving attentional focus of pupils, social-emotional learning in "at-risk" children and youth, not least, to intervene in problems of poverty and incarceration".[178] Emerging research is concerned with studying teachers and programs using mindfulness practices with students and is discovering tension arising from the moral reframing of eastern practices in western school settings. As cited by Renshaw and Cook, "Unlike most other approaches to contemporary school-based intervention, which are squarely grounded in behavioral, cognitive-behavioral, and ecological systems theories, MBIs have their origins in Eastern religious traditions".[175] Some school administrators are concerned about implementing such practices, and parents have been reported to take their children out of mindfulness programs because of their personal religious beliefs. Yet, MBIs continue to be accepted by the mainstream in both primary and secondary schools because, "Mindfulness practices, particularly in relation to children who might otherwise be considered broken or unredeemable, fill a critical niche – one that allows its advocates to imagine a world where people can change, become more compassionate, resilient, reflective, and aware; a world with a viable future".[178] As mindfulness in education continues to develop, ethical consequences will remain a controversial issue because the generic description for the "benefits" and "results" of MBIs are largely concerned with individual and inward-focused achievement, rather than the original Buddhist ideal of global human connection.

Available research reveals a relationship between mindfulness and attention. Semple, Lee, Rosa, & Miller say, "Anxiety can impair attention and promote emotionally reactive behaviors that interfere with the development of good study skills, so it seems reasonable that increased mindfulness would be associated with less anxiety".[179] They conducted a randomized trial of Mindfulness-Based Cognitive Therapy for Children (MBCT-C) that found promise in managing anxiety for elementary school-aged children, and suggests that those who completed the program displayed fewer attention problems. In addition, Flook shows how an eight-week mindfulness awareness program was evaluated in a random and controlled school setting and measured the effects of awareness practices on executive functions in elementary school children. Their findings concluded, "Participation in the mindfulness awareness program was associated with improvements in behavioral regulation, metacognition, and overall executive functions".[180] In the study by Flook, parents and teachers completed questionnaires which propose that participation in mindfulness programs is associated with improvements in child behavioral regulation. These perspectives are a valuable source of data given that caregivers and educators interact with the children daily and across a variety of settings. According to Eklund, Omalley, and Meyer, "School-based practitioners should find promise in the evidence supporting mindfulness-based practices with children, parents, and educators".[176] Lastly, a third study by Zenner, Herrnleben-Kurz, and Walach concluded, "Analysis suggest that mindfulness-based interventions for children and youths are able to increase cognitive capacity of attending and learning by nearly one standard deviation and yield".[174] Application of Mindfulness-Based Interventions continue to increase in popularity and practice.[citation needed]

Mindfulness-Based Interventions are rising across western culture, but its effectiveness in school programs is still being determined. Research contends, "Mindfulness-based approaches for adults are effective at enhancing mental health, but few controlled trials have evaluated their effectiveness among young people".[181] Although much of the available studies find a high number of mindfulness acceptability among students and teachers, more research needs to be conducted on its effects on well-being and mental health for students. In a firmly controlled experiment, Johnson, Burke, Brinkman, and Wade evaluated "the impact of an existing and widely available school-based mindfulness program". According to their research, "no improvements were demonstrated on any outcome measured either immediately post-intervention or at three-month follow-up".[182] Many questions remain on which practices best implement effective and reliable mindfulness programs at schools, and further research is needed to identify the optimal methods and measurement tools for mindfulness in education.[citation needed]

Business

Mindfulness training appears to be getting popular in the business world, and many large corporations have been incorporating mindfulness practices into their culture.[183][184][185] For example, companies such as Google, Apple, Procter & Gamble, General Mills, Mayo Clinic, and the U.S. Army offer mindfulness coaching, meditation breaks and other resources to their employees to improve workplace functioning.[183][186]

The introduction of mindfulness in corporate settings still remains in early stages and its potential long-term impact requires further assessment. Mindfulness has been found to result in better employee well-being,[187] lower levels of frustration, lower absenteeism and burnout as well as an improved overall work environment.[186]

Law

Legal and law enforcement organizations are also showing interest in mindfulness:[188]

  • Harvard Law School's Program on Negotiation hosted a workshop on "Mindfulness in the Law & Alternative Dispute Resolution."[189]
  • Many law firms offer mindfulness classes.[185]

Prison-programs

Mindfulness has been taught in prisons, reducing hostility and mood disturbance among inmates, and improving their self-esteem.[190] Additional studies indicate that mindfulness interventions can result in significant reductions in anger, reductions in substance use, increased relaxation capacity, self-regulation and optimism.[191][192]

Government

Many government organizations offer mindfulness training.

Coping Strategies is an example of a program utilized by United States Armed Forces personnel.[citation needed] The British Parliament organized a mindfulness-session for its members in 2014, led by Ruby Wax.[web 28]

Scientific research

Effects and efficacy of mindfulness practice

Mindfulness has gained increasing empirical attention since 1970

stress reduction.[27][194] Meta analyses indicate its beneficial effects for healthy adults,[20][195][196] for adolescents and children,[174][34] as well as for different health-related outcomes including weight management,[197][198][199] psychiatric conditions,[200][201][202] heart disease,[62][56] sleep disorders,[203][204][205] cancer care,[206][207][208][209] adult autism treatment,[210] multiple sclerosis,[211][212] and other health-related conditions.[213][214][215] An often-cited meta-analysis on meditation research published in JAMA in 2014,[216] found insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep, and weight, but found that there is moderate evidence that meditation reduces anxiety, depression, and pain. However, this study included a highly heterogeneous group of meditation styles (i.e., it did not focus exclusively on mindfulness meditation), which is a significant limitation of this study. Additionally, while mindfulness is well known to have positive psychological effect among individuals diagnosed with various types of cancers,[209] the evidence is unclear regarding its effectiveness in men with prostate cancer.[208]

Thousands of studies on meditation have been conducted, though the methodological quality of some of the studies is poor. Recent reviews have described many of these issues.[3][35][217] Nonetheless, mindfulness meditation is a popular subject for research, and many present potential benefits for a wide array of conditions and outcomes. For example, the practice of mindfulness has also been used to improve athletic performance,[218][31] as a beneficial intervention for children with special needs and their caregivers,[219][220][221] as a viable treatment option for people with insomnia[222][223] an effective intervention for healthy aging,[224][225][226] as a strategy for managing dermatological conditions[227] and as a useful intervention during early pregnancy.[228][229][230] Recent studies have also demonstrated that mindfulness meditation significantly attenuates physical pain through multiple, unique mechanisms.[231] Meditation also may allow one to modulate pain. When exposed to pain from heating, the brain scans of the mindfulness meditation participants (by use of functional magnetic resonance imaging) showed their brains notice the pain equally, however it does not get converted to a perceived pain signal. As such they experienced up to 40–50% less pain.[232]

Research has also investigated mindful movements and mindful exercises for different patient populations.[233][234]

Neurological studies

Research studies have also focused on the effects of mindfulness on the brain using neuroimaging techniques, physiological measures and behavioral tests.

Alzheimer's disease.[240] Additionally, mindfulness-induced emotional and behavioral changes have been found to be related to functional and structural changes in the brain.[239][241] It has also been suggested that the default mode network of the brain can be used as a potential biomarker for monitoring the therapeutic benefits of meditation.[242] Recent research also suggest that the practice of mindfulness could influence genetic expression leading to a reduced risk of inflammation-related diseases and favourable changes in biomarkers.[243][244]

Grey matter concentrations in brain regions that regulate emotion, self-referential processing, learning and memory processes have shown changes in density following MBSR.[245][242] Additionally, MBSR practice has been associated with improvement of the immune system[3][58] which could explain the correlation between stress reduction and increased quality of life.[246] Part of these changes are a result of the thickening of the prefrontal cortex (executive functioning) and hippocampus (learning and memorisation ability), the shrinking of the amygdala (emotion and stress response) and the strengthening of the connections between brain cells.[247][248][249] Long-term meditators have larger amounts of gyrification ("folding" of the cortex, which may allow the brain to process information faster) than people who do not meditate. Further, a direct correlation was found between the amount of gyrification and the number of meditation years, possibly providing further proof of the brain's neuroplasticity, or ability to adapt to environmental changes.[247]

Associations of mindfulness with other variables

Mindfulness (as a trait, distinguished from mindfulness practice) has been linked to many outcomes. In an overview,[36] Keng, Smoski, and Robins summarize: "Trait mindfulness has been associated with higher levels of life satisfaction, agreeableness, conscientiousness, vitality, self esteem, empathy, sense of autonomy, competence, optimism, and pleasant affect. A 2020 study found links between dispositional mindfulness and prosocial behavior.[250] Studies have also demonstrated significant negative correlations between mindfulness and depression, neuroticism, absentmindedness, dissociation, rumination, cognitive reactivity, social anxiety, difficulties in emotion regulation, experiential avoidance, alexithymia, intensity of delusional experience in the context of psychosis, and general psychological symptoms." (References to underlying studies omitted from quotation.)

Effects on mindfulness

The mechanisms that make people less or more mindful have been researched less than the effects of mindfulness programmes, so little is known about which components of mindfulness practice are relevant for promoting mindfulness. For example, meta-analyses have shown that mindfulness practice does increase mindfulness when compared to active control groups.[34][196] This may be because we do not know how to measure mindfulness. It could also be that mindfulness is dose-dependent and increases with more experience.[251][252] To counter that, Bergomi et al.[253] found that "results provide evidence for the associations between self-reported mindfulness and meditation practice and suggest that mindfulness is particularly associated with continued practice in the present, rather than with accumulated practice over years."

Some research into other mechanisms has been done. One study[254] conceptualized such mechanisms in terms of competition for attention. In a test of that framework, mindfulness was found to be associated (as predicted) with having an activated intention to be mindful, with feeling good, and with not being hurried or very busy. Regarding the relationship between feeling good and being mindful, a different study[255] found that causality probably works both ways: feeling good increases mindfulness, and mindfulness increases feeling good.

One theory suggests an additional mechanism termed as reperceiving. Reperceiving is the beneficial effect that comes after the process of being mindful after all the intention, attention, and attitude has been experienced. Through reperceiving there is a shift in perspective. Reperceiving permits disassociation from thoughts, emotions, and physical sensations, and allows one to exist with them instead of being defined by them.[256]

Concerns and criticism

Scholarly research

Many of the above cited review studies also indicate the necessity for more high-quality research in this field such as conducting intervention studies using larger sample sizes, the use of more randomized controlled studies and the need for providing more methodological details in reported studies.[3][36] The majority of studies also either measure mindfulness as a trait, and in research that use mindfulness interventions in clinical practice, the lack of true randomisation poses a problem for understanding the true effectiveness of mindfulness. Experimental methods using randomised samples, though, suggest that mindfulness as a state or temporary practice can influence felt emotions such as disgust and promote abstract decision-making.[257][258][259] There are also a few review studies that have found little difference between mindfulness interventions and control groups, though they did also indicate that their intervention group was treated too briefly for the research to be conclusive.[260][261] In some domains, such as sport, a lack of internal validity across studies prevents any strong claims being made about the effects of mindfulness.[31] These studies also list the need for more robust research investigations. Several issues pertaining to the assessment of mindfulness have also been identified including the current use of self-report questionnaires.[3][36][262] Potential for bias also exists to the extent that researchers in the field are also practitioners and possibly subject to pressures to publish positive or significant results.[8]

Various scholars have criticized how mindfulness has been defined or represented in recent Western psychology publications.[104][263] These modern understandings depart significantly from the accounts of mindfulness in early Buddhist texts and authoritative commentaries in the Theravada and Indian Mahayana traditions.[263]: 62 [264] Adam Valerio has introduced the idea that conflict between academic disciplines over how mindfulness is defined, understood, and popularly presented may be indicative of a personal, institutional, or paradigmatic battle for ownership over mindfulness, one where academics, researchers, and other writers are invested as individuals in much the same way as religious communities.[138]

Shortcomings

The popularization of mindfulness as a "commodity"[web 29] has been criticized, being termed "McMindfulness" by some critics.[web 30][web 31][265] According to John Safran, the popularity of mindfulness is the result of a marketing strategy:[web 29] "McMindfulness is the marketing of a constructed dream; an idealized lifestyle; an identity makeover."[266][web 29] The psychologist Thomas Joiner says that modern mindfulness meditation has been "corrupted" for commercial gain by self-help celebrities, and suggests that it encourages unhealthy narcissistic and self-obsessed mindsets.[267][268]

According to Purser and Loy, mindfulness is not being used as a means to awaken to insight in the "unwholesome roots of greed, ill will and delusion,"[web 30] but reshaped into a "banal, therapeutic, self-help technique" that has the opposite effect of reinforcing those passions.[web 30] While mindfulness is marketed as a means to reduce stress, in a Buddhist context it is part of an all-embracing ethical program to foster "wise action, social harmony, and compassion."[web 30] The privatization of mindfulness neglects the societal and organizational causes of stress and discomfort, instead propagating adaptation to these circumstances.[web 30] According to Bhikkhu Bodhi, "[A]bsent a sharp social critique, Buddhist practices could easily be used to justify and stabilize the status quo, becoming a reinforcement of consumer capitalism."[web 30] The popularity of this new brand of mindfulness has resulted in the commercialization of meditation through self-help books, guided meditation classes, and mindfulness retreats.

Mindfulness is said to be a $4bn industry. More than 60,000 books for sale on Amazon have a variant of "mindfulness" in their title, touting the benefits of Mindful Parenting, Mindful Eating, Mindful Teaching, Mindful Therapy, Mindful Leadership, Mindful Finance, a Mindful Nation, and Mindful Dog Owners, to name just a few.[269]

Buddhist commentators have criticized the movement as being presented as equivalent to Buddhist practice, while in reality it is very possibly denatured with undesirable consequences, such as being ungrounded in the traditional reflective morality and therefore, astray from traditional Buddhist ethics. Criticisms suggest it to be either de-moralized or re-moralized into clinically based ethics. The conflict is often presented with concern to the teacher's credentials and qualifications, rather than the student's actual practice. Reformed Buddhist-influenced practices are being standardized and manualized in a distinct separation from Buddhism - which is seen as a religion based in monastic temples - and expressed as “mindfulness” in a new psychology ethic, practiced in modern meditation centers.[270]

Risks

In media reports, people have attributed unexpected effects of increasing fear and anxiety, panic or "meltdowns" after practicing, which they suggest could expose bipolar vulnerability or repressed

PTSD symptoms.[271] However, according to published peer-reviewed academic articles, these negative effects of meditation are rare for mindfulness meditation,[3][272][273] and appear to happen due to a poor understanding of what actually constitutes mindfulness/meditation practices.[6][272]

See also

Notes

  1. ^ a b Baer cites Kabat-Zinn, J. (1994): Wherever you go, there you are: Mindfulness meditation in everyday life. New York: Hyperion, p.4.
  2. vipassana, namely Sampajañña discerning what is beneficial and what is not, and calming the mind by this discernment.[12][13][14]
  3. ^ Kabat-Zinn, in Full Catastrophe Living (Revised Edition) (2013), p. lxiv advises to use CD's with guided mindfulness practices: "Almost everybody finds it easier, when embarking for the first time on a daily meditation practice, to listen to an instructor-guided audio program and let it "carry them along" in the early stages, until they get the hang of it from the inside, rather than attempting to follow instructions from a book, however clear and detailed they may be."

    Compare Rupert Gethin (2004), On the practice of Buddhist meditation, pp. 202–03, noting that the Buddhist sutras hardly explain how to meditate, and then stating that "the effective practice of meditation requires the personal instruction of a teacher." Gethin seems to echo Vetter (1988), The Ideas and Meditative Practices of Early Buddhism, who notes that the Dhammacakkappavattana Sutta describes the Buddha as instructing his first followers in turn: instructing two or three of them, while the others go out begging for food, signifying the need for personal instruction to learn ho to practice dhyana.
  4. ^ See also Eating One Raisin: A First Taste of Mindfulness for a hand-out file
  5. ^ Quotes from Gethin, Rupert M.L. (1992), The Buddhist Path to Awakening: A Study of the Bodhi-Pakkhiȳa Dhammā. Brill's Indological Library, 7. Leiden and New York: Brill
  6. ^ Dreyfus concludes his examination by stating: "[T]he identification of mindfulness with bare attention ignores or, at least, underestimates the cognitive implications of mindfulness, its ability to bring together various aspects of experience so as to lead to the clear comprehension of the nature of mental and bodily states. By over-emphasizing the nonjudgmental nature of mindfulness and arguing that our problems stem from conceptuality, contemporary authors are in danger of leading to a one-sided understanding of mindfulness as a form of therapeutically helpful spacious quietness. I think that it is important not to lose sight that mindfulness is not just a therapeutic technique but is a natural capacity that plays a central role in the cognitive process. It is this aspect that seems to be ignored when mindfulness is reduced to a form of nonjudgmental present-centered form of awareness of one's experiences.[87]
  7. ^ Sharf: "Mahasi's technique did not require familiarity with Buddhist doctrine (notably abhidhamma), did not require adherence to strict ethical norms (notably monasticism), and promised astonishingly quick results. This was made possible through interpreting sati as a state of "bare awareness"—the unmediated, non-judgmental perception of things "as they are," uninflected by prior psychological, social, or cultural conditioning. This notion of mindfulness is at variance with premodern Buddhist epistemologies in several respects. Traditional Buddhist practices are oriented more toward acquiring "correct view" and proper ethical discernment, rather than "no view" and a non-judgmental attitude."[web 9]
  8. ^ "The word derives from a verb, sarati, meaning "to remember," and occasionally in Pali sati is still explained in a way that connects it with the idea of memory. But when it is used in relation to meditation practice, we have no word in English that precisely captures what it refers to. An early translator cleverly drew upon the word mindfulness, which is not even in my dictionary. This has served its role admirably, but it does not preserve the connection with memory, sometimes needed to make sense of a passage.[web 10]
  9. ^ Black: "[S]everal decades of research methodology and scientific discovery have defrayed these myths; mindfulness is now widely considered to be an inherent quality of human consciousness. That is, a capacity of attention and awareness oriented to the present moment that varies in degree within and between individuals, and can be assessed empirically and independent of religious, spiritual, or cultural beliefs.[96]
  10. Vipassana-meditation.[100][101][102]
  11. ^ Vipassana as taught by teachers from the Vipassana movement is a 19th-century development, inspired by and reacting against Western modernism.[117][118] See also Buddhist modernism.
  12. ^ Frauwallner, E. (1973), History of Indian Philosophy, trans. V.M. Bedekar, Delhi: Motilal Banarsidass. Two volumes., pp.150 ff
  13. dharmata, the inseparability of appearance and emptiness (two truths doctrine), clarity and emptiness, or bliss and emptiness.[web 16]
  14. DN 22; Thanissaro, 2000) and the Satipatthana Sutta
    (MN 10; Thanissaro, 1995b).
  15. apramāda (Pali: appamada).[web 17]
  16. ^ According to this correspondence, Ven. Nyanaponika spent his last ten years living with and being cared for by Bodhi. Bodhi refers to Nyanaponika as "my closest kalyāṇamitta in my life as a monk."
  17. ^ The resort to "experience" as the ground for religious truths is a strategy which goes back to Schleiermacher, as a defense against the growing influence of western rationality on the religious life of Europeans in the 19th century. See Sharf (1995), Buddhist Modernism and the Rhetoric of Meditative Experience.[118]
  18. ^ "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
  19. ^ "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)."[1]

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Further reading

Origins

Buddhism

Psychology

Other

Critical