Mindfulness as Medicine · mindfulness that Kabat-Zinn and others identify: •Pay close attention...

Mindfulness as Medicine

Janet Marinelli, M.S., Assistant Professor

Master of Arts in Holistic Health Studies Program

St. Catherine University

Mindfulness

• Paying attention

• In the present moment

• Without judgment

• During any activity

• Culturally rooted in Eastern philosophy (Buddhism)

• Translated into Western healthcare

“Mindfulness means maintaining a moment-by- moment awareness of our thoughts, feelings, bodily sensations, and surrounding environment.”

http://greatergood.berkeley.edu/topic/mindfulness/definition

“Mindfulness is a state of active, open attention to the present. When you’re mindful, you observe your thoughts and feelings from a distance, without judging them good or bad. Instead of letting your life pass you by, mindfulness means living in the moment and awakening to experience”.

http://www.psychologytoday.com/basics/mindfulness

“Simply put, mindfulness is moment-to-moment awareness. It is cultivated by purposefully paying attention to things we ordinarily never give a moment’s thought to. It is a systematic approach to developing new kinds of control and wisdom in our lives, based on our inner capacities for relaxation, paying attention, awareness, and insight.”

(Kabat-Zinn, 1990, p. 2)

Meditation

“Meditation is not an idea. Meditation is a primal human experience that has been discovered and rediscovered in every era and on every continent.”

(Monaghan and Viereck, 2011, p. 354)

Meditation is central to the idea of mindfulness.

“Mindfulness is not a technique but a state of awareness, so it is the result of a meditation practice rather than a practice itself.”

(Monaghan and Viereck, 2011, p. 90)

Types of Meditation

• Indigenous Traditions: trance dancing, drumming, ritual body postures

• Yoga: asanas, breathing, mantra, mandala

• Buddhism: vipassana or insight meditation, loving-kindness, zen in action, haiku and other meditative poetry

• Taoism: Tai Chi, Qigong

• Judaism: ethical introspection, conversations with God

• Christianity: contemplative prayer, taize’ singing, Quaker worship

• Islam: Sufi breathing, Sufi dancing

• Mixed and Modern forms: inspirational reading, labyrinth walking, biofeedback, the body scan

• Creative Meditations, needle crafts, journaling, visualizations

• Active meditations: sports as meditation, gardening, nature

(Monaghan and Viereck, 2011, from table of contents)

History

• Exploration of Eastern practices in the 1950’s and 1960’s (and prior to this time)

• Herbert Benson’s relaxation response

• Joan Borysynko’s work

• Jon Kabat-Zinn, molecular biologist, explored meditation in 1960’s

• Kabat-Zinn developed Mindfulness Based Stress Reduction (MBSR) in 1979 at the University of Massachusetts Stress Reduction Clinic

Cultural Roots

“MBSR and its “cousins” are expressions, however limited they may be in some regards, of the deep wisdom stemming from practices discovered and refined long ago in India and kept alive and refined further over millennia by multiple traditions—mostly but no exclusively Buddhism—in all the civilizations of Asia.”

(Kabat-Zinn, 2013, p. 603)

Monkey Mind/Roof Brain Chatter

Mind Wandering

Herbert Benson’s

Relaxation Response • http://www.psychologytoday.com/blog/heart-and-soul-healing/201303/dr-

herbert-benson-s-relaxation-response

• http://www.health.harvard.edu/blog/using-the-relaxation-response-to-reduce-stress-20101110780

• http://brainworldmagazine.com/dr-herbert-benson-on-the-mindbody-connection/

Benefits of Mindfulness

• Reduces stress

• Strengthens immune system

• Lowers blood pressure

• Reduces chronic pain

• Improves sleep

• Used with heart disease, gastrointestinal illness, and support for cancer care

• Reduces depression and anxiety while increasing well-being and happiness

• Improves social relationships

• Increases openness to experience

Dialog

Challenges facing physical therapists…

How mindfulness might support you in your work…

Applications to patient care…

Psychosynthesis Disidentification Exercise

http://two.not2.org/psychosynthesis/exer/ctr-di.htm

http://aap-psychosynthesis.org/

Outline of MBSR Program

• Eight weeks

• Structured curriculum

• Breathing, body scan, yoga, sitting meditation

• 45 minutes per day, 6 days per week

(Kabat-Zinn, 2013, Chapter 10)

Key Components of Practicing Mindfulness

“Here are a few key components of practicing mindfulness that Kabat-Zinn and others identify:

• Pay close attention to your breathing, especially when you’re feeling intense emotions.

• Notice—really notice—what you’re sensing in a given moment, the sights, sounds, and smells that ordinarily slip by without reaching your conscious awareness.

• Recognize that your thoughts and emotions are fleeting and do not define you, an insight that can free you from negative thought patterns.” http://greatergood.berkeley.edu/topic/mindfulness/definition

Selected Research

• In 2005, 100 papers in the related literature

• In 2013, 1500 papers in the related literature

(Kabat-Zinn, 2013, p. xxx)

Alterations in Brain and Immune Function

• Focus on biological mechanisms

• Randomized controlled study with 8 week clinical program in mindfulness meditation

• 25 healthy employees in their workplace

• Following 8 week program subjects and control group (16) received influenza vaccine

(Davidson et. al, 2003, p. 564)

“Results: We report for the first time significant increases in left-sided anterior activation, a pattern previously associated with positive affect, in the meditators compared with the nonmeditators. We also found significant increases in antibody titers to influenza vaccine among subjects in the meditation compared with those in the wait-list control group. Finally, the magnitude of increase in left-sided activation predicted the magnitude of antibody titer rise to the vaccine.” (Davidson, et. al., 2003, p. 564)

Mindfulness Research Update: 2008

Results from a review of 52 research articles:

“Both basic and clinical research indicate that cultivating a more mindful way of being is associated with less emotional distress, more positive states of mind, and better quality of life. In addition, mindfulness practice can influence the brain, the autonomic nervous system, stress hormones, the immune system, and health behaviors, including eating, sleeping, and substance use, in salutary ways.”

(Greeson, 2008, p.1)

Effects of Mindfulness on Psychological

Health: A Review of Empirical Studies

“Based on an examination of empirical literature across multiple methodologies, this review concludes that mindfulness and its cultivation facilitates adaptive psychological functioning.”

(Keng, Smoski,& Robins, 2011, p. 1052)

Positive Psychological Effects

• Increased sense of well-being

• Reduced psychological symptoms

• Reduced emotional reactivity

• Improved control of behavior

(Keng, Smoski,& Robins, 2011)

Cultivating Mindfulness in Health Care

Professionals: A Review of Studies of MBSR

• High rates of burnout and stress in healthcare professionals

• Can lead to “fatigue, insomnia, heart disease, depression, obesity, hypertension, infection, carcinogenesis, diabetes, and premature aging”

(Irving, Dobson, & Clark, 2009)

Benefits of MSBR for Health Care

Professionals

• Decreased anxiety and depression

• Increased empathy and spirituality

• Decreased symptoms of burnout

• Increased relaxation

• Increased life satisfaction

• Increased self compassion

• Clients reported better therapeutic relationships (psychotherapists) (Irving, Dobson, & Clark, 2009)

Brief Online Mindfulness Meditation

• 104 students assigned to mindfulness intervention or control group

• Engaged in two weeks of self-directed, online mindfulness meditation

• Results suggest an increase in mindfulness and a decrease in self-reported stress, anxiety and depression.

(Cavanagh, Strauss, Cicconi, Griffiths, Wyper, & Jones, 2013)

Mindfulness and Self-Help:

Meta-analysis

• Fifteen studies reviewed

• Related to effectiveness of low intensity mindfulness and acceptance-based self-help methods

• Promising results

(Cavanagh, Strauss, Forder, & Jones, 2014)

Resources

Listing of Mindfulness and Meditation Centers in Minneapolis/St. Paul, Rochester, and the Region (from the Center for Spirituality and Healing, University of Minnesota)

www.csh.umn.edu/.../documents/content/ahc_content_313535.doc

References

Cavanagh, K., Strauss, C., Cicconi, F., Griffiths, N., Wyper, A., & Jones, F. (2013). A randomised controlled trial of a brief online mindfulness-based intervention. Behaviour Research and Therapy, 51(9), 573-578. doi:10.1016/j.brat.2013.06.003

Cavanagh, K., Strauss, C., Forder, L., & Jones, F. (2014). Can mindfulness and acceptance be learnt by self-help?: A systematic review and meta-analysis of mindfulness and acceptance-based self-help interventions. Clinical Psychology Review, 34(2), 118-129. doi:10.1016/j.cpr.2014.01.001

Davidson, R.J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S.F.,Urbanowski, F., Harrington, A., Bonus, K., & Sheridan, J.F. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564-570.

Greeson, J. M. (2009). Mindfulness research update: 2008. Complementary Health Practice Review, 14(1), 10-18. doi:10.1177/1533210108329862

Irving, J. A., Dobkin, P. L., & Park, J. (2009). Cultivating mindfulness in health care professionals: A review of empirical studies of mindfulness-based stress reduction (MBSR). Complementary Therapies in Clinical Practice, 15(2), 61-66. doi:10.1016/j.ctcp.2009.01.002

Kabat-Zinn, J., & University of Massachusetts Medical Center/Worcester. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York, N.Y: Dell Publishing.

Kabat-Zinn, J. (2013). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York, N.Y: Bantam Books.

Keng, S., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: A review of empirical studies. Clinical Psychology Review, 31(6), 1041-1056. doi:10.1016/j.cpr.2011.04.006

Monaghan, P., & Viereck, E. (2011). Meditation--the complete guide: Techniques from east and west to calm the mind, heal the body, and enrich the spirit. Novato, CA: New World Library.