Lecture 14: Mindfulness

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What is mindfulness?  In popular understanding mindfulness is often referred to as “emptying of the mind.”  An absolute emptying of the mind may not be possible straightaway, therefore, techniques such as awareness of breathing and body sensation are used as anchors to relax the body while keeping the mind attentive.  In the words of a report from the UK-based Mental Health Foundation, “Mindfulness is a way of paying attention to the present moment by using meditation, yoga and breathing techniques.  It involves consciously bringing awareness to our thoughts and feelings, without making judgments…” (MHF, 2010, p. 12).  Shapiro (2009, p.556) defines mindfulness as “the awareness that arises through intentionally attending in an open, accepting, and discerning way to whatever is arising in the present moment.”  Mindful awareness is the outcome of intentional attending (Shapiro & Carlson, 2009).  The other common definition is from Jon Kabat-Zinn (1994, p.4): “Mindfulness means paying attention in a particular way: on purpose, in the present moment, and nonjudgementally.”  The three adjectives in the second part of the sentence are crucial.  Mindfulness is an intentional activity.  It pays attention to the present; therefore, there is no sense of guilt about the past and anxiety about the future.  It entails being non-judgemental, that is, the individual does not classify their thoughts and sensations as good or bad.  They are just mindful or aware!

Mindfulness is increasingly being used in clinical contexts (Mars & Abbey, 2010).  In theUK, for instance, the National Institute for Health and Clinical Excellence (NICE, 2004) recommended Mindfulness-Based Cognitive Therapy (MBCT) for people who had experienced depression.  This was further confirmed by a research published by the Mental Health Foundation (MHF, 2010) that reported that out of the 250 General Practitioners (GP) surveyed, 72% think it would be helpful for their patients with mental health problems to learn mindfulness meditation skills.  In a representative sampling of 2,007 British adults, 51% of those surveyed said they would be interested in attending free meditation classes to help them deal with stress and thus look after their health.

There are some specific approaches in psychotherapy that have integrated mindfulness based interventions.  Mindfulness-Based Cognitive Therapy (MBCT) was developed by Segal, Williams and Teasdale (2002) as a therapy for relapse prevention of major depression.  Kabat-Zinn’s (2003) Mindfulness-Based Stress Reduction (MBSR) integrates components of Cognitive Behavioural Therapy (CBT; Beck, 1993).  Meta-analyses and systematic reviews on the available data on the effectiveness of mindfulness-based interventions report very mixed findings.  For instance, evidence for a beneficial effect of MBSR on depression and anxiety was equivocal (Toneatto & Nguyen, 2007).  Whereas, there is other evidence that suggests that mindfulness-based intervention might have some effect on stress reduction in healthy subjects (Chiesa & Serretti, 2009).  Other results show that mindfulness-based therapy is a promising intervention for treating anxiety and mood problems in clinical populations (Hofmann, Sawyer, Witt, & Oh, 2010; O’Driscoll, 2009).

In general, as Baer (2003, p.140) has suggested, although the “empirical literature supporting its efficacy is small,” there is a growing support for the claim that “mindfulness-based intervention can be rigorously operationalized, conceptualized, and empirically evaluated” in the context of health and wellbeing (see also Kabat-Zinn, 2003).   Others suggest that “the combination of some well-developed conceptual models for the therapeutic action of mindfulness and a developing empirical base, justifies a degree of optimism that mindfulness-based approaches will become helpful strategies to offer in the care of patients with a wide range of mental and physical health problems” (Allen et al., 2006, p.285).

In positive psychology, mindfulness is used as a means to facilitate novelty, flow and optimal experiences, and its relation to spirituality is also duly acknowledged (Snyder & Lopez, 2007).  The suitability of mindfulness as a viable intervention technique in positive psychology is supported by the possibility that the principles and practice of mindfulness are similar to most basic elements of positive psychology.  Since, “mindfulness meditation promotes positive adjustment by strengthening meta-cognitive skills and by changing schemas related to emotion, health, and illness,” Hamilton and colleagues (2006, p.123) suggest that mindfulness holds the promise of being “a link between positive psychology and cognitive behavioural therapies.”  Furthermore, in examining the qualities of mindfulness that have parallels with positive psychology, Shapiro and colleagues (2002, p.640) list the following: non-judging, non-striving, acceptance, patience, trust, openness, letting go, gentleness, generosity, empathy, gratitude, and loving kindness.  While some of these qualities are directly related to the list of character-strengths, others can have at least an extended denotation.  For instance, the description of patience and trust could be related to hope, non-judging quality to wisdom, letting-go to forgiveness, and acceptance to faith.