Who can be helped by a mindfulness approach to psychotherapy?
Nearly every issue that people traditionally seek help for in psychotherapy would also be appropriate for a mindfulness approach. Are you struggling with difficult emotions? Or navigating an important life transition, such as moving, career change, marriage, illness and the like? Are there some important relationships in your life that could be better?
Just as your psychology can color everything you think, feel, sense, or do, so mindfulness can help you become more aware of what’s going on within yourself, or between you and others. For example, many people carry lifelong psychological habits which are both unique and universal. Some people are self-critical, or have a tendency to worry. Some might be competitive, while others doubt themselves. Some find themselves caught in patterns that limit the success of their relationships, whether with one’s life partner or with co-workers, although they are not sure how.
Mindfulness dovetails with the aims of therapy in greeting each experience with respect and curiosity, in full confidence that this quality of awareness has the power to transform experience and personality. The aim is to create a container of perspective and compassion, a place and process of stepping back and looking at what is happening. By patiently examining the layers of experience, one cultivates the skills of mindfulness while at the same time getting down to the roots of what is not working, and why. Overall, mindfulness and psychotherapy together aim to cultivate a greater connection to self that decreases the need to avoid certain areas of vulnerability and defense that results in costly symptoms. It aims at helping people develop a more compassionate way of relating to self, leading to a more vibrant and authentic experience of self and relationship.
Internet and Mindfulness
The Internet has proven to be mesmerizing, and the tide of its usage is rising exponentially. In the mid-1990s, a psychiatrist coined the term “Problematic Internet Use” (PIU) as a joke, but with one in four adults using the internet to the point of disrupting their daily functioning, most people would recognize internet addiction as a very real and relevant problem today. Proliferation of apps and devices to share experiences and to tap the growing volume of digital information is removing barriers to being online all the time, prompting catch phrases like “digital anarchy” and “look down generation.” For many, checking their device for messages or using some other app is the first thing they do when they open their eyes in the morning.
The internet is so mesmerizing that many people can’t seem to put down their phones even when they’re driving, and other situations where the choice to remain glued to an app puts themselves and others in danger. One recent study in the UK reported that over 40% of people reported walking into something while using a phone, and another study reports dramatically higher pedestrian mortality rates associated with walking and texting, especially with children and teens.
Aside from these physical dangers, increasing internet use is taking a toll on the cognitive and psychological functions of populations as well. The constant switching of attention by checking email, texts, following hyperlinks, notifications, etc. is impairing the capacity to concentrate and stay focused on tasks for any amount of time. The pattern of internet and smartphone usage is reducing the average amount of time spent focusing on a single activity as 11 minutes in one study, and as low as. I 2 minutes in another. In another workplace study people reported losing as much as 60% of their workday productivity to such interruptions. “Digital dementia” refers to the way in which people are thinking less for themselves and relying more on googling for solutions. The capacity to read, the capacity to focus and concentrate, the capacity to reflect, imagine, to develop empathy, and possibly overall intellectual capacity are all skills that are being eroded through the way we use the internet.
Finally, having one or more gadgets that is literally on hand all day (and sometimes nights) is disruptive to connection and presence, two qualities that are critical to happiness and well-being. This is troublesome, but particularly concerning when it interferes with the development of social skills in young people. Teens and young adults who may feel shy or self-conscious in social contexts might feel it is easier or less emotionally risky to interact with others with a screen mediating between them.
Mindfulness is both a desirable skill and a series of systematic steps that can help people develop presence and greater self-awareness. It provides a means to interrupt the addiction to reactivity, novelty-seeking and preference for virtual, as opposed to real, reality. It can be an antidote to people who are getting disconnected by grounding them in their own body. Starting with self-connection and improved social connections with others, mindfulness can provide a path to a sense of vitality and well-being.
Mindfulness-oriented psychotherapy and adjunct treatment may be critical if the internet is related to as a virtual reality that provides a form of distraction or escape from a person’s real life and functioning. Like any other addiction, it could be that internet addiction has taken on a life of its own and vigorous treatment such as inpatient hospitalization or residential rehabilitation is needed to break the addiction. However for most people, it could be as simple as being aware of the impulse to check the device and reducing how often you reach for it. It could be relaxing by taking a walk instead of surfing the internet, or talking to someone on the telephone instead of testing or emailing.
How exactly does mindfulness work to transform me?
Awareness and Attention
What are the first words that come to mind when you are asked to define mindfulness? Chances are good that awareness and attention are up there on the list. When you go to see a doctor the first thing you are asked is: “what’s going on?” Your answer may refer to context: “my job is stressful;” body: “a pain in my leg;” or psychological: “I worry a lot.” “What’s going on?” is the core question of mindfulness, and awareness and attention is how you answer it. By turning attention to what’s going on, whether it is thoughts and ideas, emotions, bodily sensations, perceptions or anything else, you cultivate mindfulness.
You can appreciate the value of awareness and attention by considering the alternative – what it looks like in its absence. We’ve all experienced interacting with someone who isn’t there – perhaps a call center helper where the conversation goes nowhere because they are not paying attention. Or when you drive past your exit on the highway.
For most of us this happens because we are on automatic pilot, or lost in thought. Like surfing on the web, the mind’s stream of consciousness entices one to get absorbed and follow it to wherever it is going. Stream of consciousness, daydreaming, and reactivity can use up the bulk of one’s mental bandwidth, somewhat akin to spending the day in front of the TV.
Awareness interrupts the automatic pilot quality of being lost in thought. Awareness also helps loosen the grip when reactivity is strong and automatic. Suppose you or someone you know tends to complain a lot. The habit of focusing on the negative of a situation and feeling resentful about it is automatic, and may dominate a person’s day. Awareness calls upon a person to recognize when that reaction kicks in, and thereby loosen that entrenched habit of mind.
Closely connected to awareness is acceptance, or awareness which is not judgmental. Nonjudgmental awareness is a form of radical acceptance.
Everyone has patterns of reactivity which are formed over years of living. We become conditioned to patterns of thinking and feeling, including judgments, attitudes, self-criticism, views about what is acceptable, or what is not. This conditioning is literally hard-wired into our brain and it is often extremely difficult to think or feel otherwise than the way we do. Accepting this reality is part of the process of increasing awareness and mindfulness. The therapeutic relationship plays a key part in the cultivation of this acceptance, so that an individual may become increasingly free in their capacity to explore their own mind and inner world in a more spontaneous and open way.
Mindfulness and psychotherapy are both processes whose original intent was to address human mental suffering. Without compassion neither therapy nor mindfulness would be meaningful or effective. People often suffer because they find their own experience too painful to bear, and come for help to get away from it, to repel it, or reject it. In reality the key ingredient of healing is compassion, the ability to be with suffering with kindness and care. Thus both processes deliberately seek to cultivate a person’s capacity for compassion and empathy.
Awareness, acceptance, compassion and non-judgment are not abstract concepts, but highly charged, highly sophisticated activities of the human mind.
They are not really ideas to be intellectualized in the past or in the future, but processes that can only occur in the present moment. Both meditation and psychotherapy are a form of being in the present, a kind of pledge to oneself to arrive into the present, an investment of time and effort, a belief that it is important enough to do — and finally an actual experience of being. It is not meant to be pleasurable or uncomfortable – it could easily be either or anything in between – but simply whatever it is. When people do experience the present moment, their minds neither distracted, nor projecting into the future nor ruminating over the past, they often find the experience deeply healing and satisfying. Indeed brain research has demonstrated that a different part of the brain is activated when one is present and mindful, and that happiness and peace is activated. Read more about present moment awareness on this page.
Openness and Curiosity
Curiosity is a high form of intelligence, and paired with authentic presence and nonjudgmental awareness, extraordinarily powerful. Curious awareness is also a mental activity valued and encouraged in psychodynamic therapies and is closely tied to tolerance or equanimity. It implies that what is to be seen or experienced within oneself need not be feared or rejected, but may have value in ways that can’t be forseen. It is the openness to explore, unconditioned by the need to repel, close down, or manage what is being investigated.
Emotion Regulation / Reactivity / Nonreactivity
A key aspect of mindfulness practice is to turn not away from, but toward, the undesirable and feared experience, such as pain.
Mindfulness-Based Stress Reduction (MBSR) has been extraordinarily successful in expanding traditional medicine’s utilization of mind-body approaches to traditional disease conditions such as chronic pain. In fact, upon close examination it has become obvious that the muscular and nervous tension generated by the expectation of discomfort can not only aggravate the original problem but compound the problem by making the condition worse and adding new disease conditions on top of it (such as hypertension and other psychoneuroimmune-mediated conditions, such as inflammation). It is the reactivity itself that can turn a medical or emotional problem into an even bigger one.
By investing energy in avoiding difficult mental states, the capacity to be loose is compromised. In contrast, the work of mindfulness on emotional regulation might be likened to an athlete whose tight muscles are restricting their talent. Stretching or expanding tolerance of new or difficult emotions should not happen forcefully or be “powered through.” Rather the desired state of suppleness and flexibility is achieved bit by bit. Mindfulness helps emotional regulation by developing the capacity to meet what arises not with rejection and tension, but with openness, and even, eventually, friendly welcome.
How do mindfulness and psychotherapy work together?
Mindfulness and psychotherapy both develop “skills” that dovetail very closely. These include skills of open-mindedness and curiosity, non-judgmental awareness and exploration, which in turn lead to compassion, self-acceptance, and comfort in the present moment.
In psychotherapy these are skills that are developed in the context of a deepening connection between therapist and patient leading to increasing sharing and freedom of expression. By gradually increasing tolerance and allowing exploration, not just of the “problem” state but of the mind itself, mindfulness and psychotherapy both help the mind to relax, and in its relaxation, the mind heals.
Another important skill is staying present. Many mental states live in the past or in the future. Regret looks behind while worry looks ahead. What we want and don’t have yet, or what we should have done differently. While planning and reviewing are important cognitive skills — part of what neuropsychologists call executive functioning — in present society they are skills that are in overdrive, like an engine revving without going anywhere. Not only that, people’s specific histories and makeup put a stamp on the ways in which their minds have difficulty staying present. Some individuals are stuck in the past in the form of regret and the need for a “do-over.” Others are firmly focused on the future in terms of achievement, ambition, or performance. Happiness is conceptualized as contingent on their future ability to accomplish their goals. Goals are important and even necessary for optimum functioning, but to the extent that it leaves some people un-centered and unable to live comfortably in the present, it is a form of imbalance. In its most extreme form, people suffering obsessive compulsive symptoms feel locked or trapped in their dread of undesirable future outcomes.
The importance of cultivating present moment awareness in the context of worry and bias
Mindful psychotherapy calls repeatedly on the patient to notice what is occurring in the here and now as a way of setting the “compass” of the mind to the true north of reality.
While understanding what has happened in the past and what is hoped for or expected for the future, psychotherapy helps individuals get grounded in what is real and relevant in the present. For example, an athlete may unnecessarily hamper their present performance by allowing her thoughts and emotions to ruminate on a poor performance in last week’s game. Last week, the athlete may have slept poorly. She might have seen a text message right before the game that threw off her focus. The temperature in the stadium might have been off. She may be preoccupied by an ambiguous comment from her coach. She may allow herself to succumb to her “hunch” that her coach does not support her
Mindful therapy accepts and acknowledges the complex state of feelings and thoughts that are happening, and helps the patient to relax into them. Subjective reality is honored and investigated. This helps the patient to loosen the power of fear and worry, which in turn helps people recognize the truth of present moment reality. At this moment, during this game the conditions are not the same as last week’s game. What you do now does not have to be determined by what happened before. The coach may or may not support you, but for now what is real is that this is what you fear, not what you know. Cultivating mindfulness over time helps people expand their capacity to engage with vitality with the present, versus sacrificing the present by being mentally and emotionally absorbed in the past or future.
The role of relationship in mindful psychotherapy
As valuable as awareness and insight is, they are not sufficient for change or healing. Therapy is not successful in an emotionally sterile environment, but must be accompanied by a change in attitude or heart, by the cultivation of compassion and kindness in one’s attitude toward one’s suffering.
For this the role of the therapist and the relationship of patient and therapist is critical. The therapeutic relationship is the vehicle by which a person learns to become less reactive and judgmental toward their particular difficulties – to identify with their problems less while tolerating the pain of those difficulties more. This gradual process gradually eases tension in the psyche and personality.
When therapy is successful people often come to the realization that compassion, mindful presence, sensitive awareness without judgment, empathy – are each high level psychological skills that are more than worth their weight in investment. The development of these skills allow people to accomplish their goals better, not worse. They help people become more effective, not interfere with their plans. They are developed through the intentional effort of therapist and patient, to create and hold a space together for what is difficult and unworked.
Mindfulness-based Cognitive Therapy (MBCT) and other forms of mindfulness therapies
There are a number of specific forms of mindfulness-based therapies that have been developed to address specific needs, and which call upon the skills described here.
These include Mindfulness-based Stress Reduction (MBSR) founded by Jon Kabat-Zinn, initially for the application of mindfulness to pain and chronic illness management; Mindfulness-based Cognitive Therapy (MBCT) created by Zindel Segal and colleagues as a form of melding mindfulness to the tools of Cognitive Behavioral Therapy (CBT) to address depression; Dialectic Behavior Therapy (DBT) developed by Marsha Linehan to shore up emotional regulation and consequent behavioral breakdowns; and Acceptance and Commitment Therapy (ACT) developed by Steven Hayes, a step-by-step model integrating mindfulness strategies such as not identifying with one’s thoughts and feelings yet enhancing consciousness of them. The effectiveness of these modalities in treating populations with challenging problems such as the management of chronic pain, addictions, self-harming behavior have been demonstrated through well-researched positive outcome studies and can be viewed as a kind of “proof of concept” for the skills of mindfulness.
The role of embodied awareness in mindfulness and psychotherapy
Mental and emotional states can be so varied and textured, and each individual’s personal experience of their own psychic life is very different from the next person’s. Therefore in discussing mental, emotional or spiritual phenomena it is easy for language to become abstract or amorphous.
By necessity we put language to it, but it doesn’t mean everyone understands the same thing when that language is used. This is the peril of a psychological discussion or a mindfulness one. However in reality we are biological, embodied beings. All experience is grounded within the body that houses our psyche. The body then, is the portal by which awareness can anchor. Bodily experiences are sincere and authentic. The body does not lie. Both mindfulness and psychotherapy is able to advance when awareness is anchored in embodiment.
The History of Mindfulness: How did mindfulness get started?
Mindfulness is a natural human capability, such as the capability to speak a language or to be creative. Therefore it is reasonable to assume that some form of both mindfulness and awareness of it must have occurred “as old as time,” even in prehistory, for example.
However in written and oral tradition it was the Buddha who gave the teachings that constitute the most significant body of understanding of mindfulness. The story of the Buddha and his life is the story of his discovery of the power and depth of mindfulness, and his development of a systematic and thorough methodology to cultivate this capability all the way to its natural consequence — enlightenment and liberation from human suffering. Current forms of mindfulness and meditation training draw upon the exact same methods and teachings that were recorded and practiced for the past 2500 years.
What changed recently is that mindfulness meditation and its surrounding ethos, part of many Eastern cultures for millennia, came to relevance in the West. Although Buddhism and Western civilizations occasionally intersected in remote history, it wasn’t until the 19thcentury that a smattering of influential Western intellectuals began to take notice, including philosophers, writers and converts (Nietzsche, Arnold, Schopenhauer, Blavatsky, Thoreau, Dahlke). The trickle turned into a stream in the 20th century with the introduction of Zen and Tibetan Buddhism to the West. However the beginning of its true popularization might be traced to the counter-cultural movement of the late 1950s and 1960s including spiritual seekers such as Ram Dass (born Richard Alpert and once a Stanford-trained psychologist) looked to Hinduism and Buddhism in the East for fresh insights to spiritual and psychological questions. Yoga, which was considered esoteric and “New Age” back then, is now found in every health club and fitness center and no longer considered alternative. In the 1970s a group of American meditators such as Joseph Goldstein (founder of Insight Meditation Society) returned from India and established meditation centers that gained traction in the US.
However the stream became a roar when the Age of the Brain coincided with the growing interest in mindfulness, and the novel and accessible technologies of brain imaging allowed discoveries about the benefits of meditation that captured the modern world’s imagination and created what Malcolm Gladwell would call a tipping point in public consciousness, leading to a sea change in modern culture. If the change continues, we might look back to this phase in human history and view it as a pivot as important to world as the Age of Enlightenment or other sea changes in global consciousness.
While it was the Buddha in 500 BCE that first taught about mindfulness and its power to liberate the human mind from suffering, it would be a mistake to think that mindfulness is a “Buddhist” thing or an “Eastern thing.” The famous Sermon on the Mount of Jesus is a teaching about compassion, arguably the most famous speech about compassion ever given — yet no one would think that you have to call yourself Christian to experience compassion.
Rather, mindfulness, like compassion, is not itself a fad, or a new thing, but actually an inborn human capacity. Like logic, or creativity, or language, mindfulness is a part of the human package — an especially profound one which can be cultivated to improve almost everything a person does.
What are some exercises to get started with mindfulness?
One of the ways to train awareness is by targeting an object of focus, such as s candle flame or observing the breath. Another is by narrowing the channel of observation, such as sense perception. In the former, you could focus inward on bodily sensations, thoughts, or emotions. In the latter, you could focus outward, for example, by closing your eyes and focusing on sounds in a quiet room.
When you are beginning, it is really valuable to keep it simple. Simplicity supports awareness. Therefore mindfulness of thoughts, for example, is something that might better be attempted after practice, or with the help of a teacher or therapist. It’s a little like practicing with a sailboard in a lagoon before taking it out to open ocean.
With all practices of mindfulness it’s important to approach it with a supportive attitude. Being very patient and light, not heavy-handed or with strong expectations. One of my favorite analogies is to view it like house training a new puppy. It’s not really only about discipline and control of your dog. It’s also an investment into the quality of your relationship, and the more kindness and joy you put into it, the better and more effective the rewards in the long term.
The following exercises can be practiced from 1 minute to 1 hour. As an introduction, you might try a period of 5-15 minutes.
You can be in any posture and be aware. However some postures make it easier to be mindful, and to sustain mindfulness. You can sit in straight-backed chair or a stool, or sit on a block or cushion on the floor. The important thing is to make it easy for your spine and neck to be straight and upright without being rigid or tense. If in a chair, make sure your feet are flat on the floor. Keep your head aligned with your spine; don’t bow your head or crane your neck. Being able to breathe easily is a good cue that your posture is conducive to meditating. Being comfortably alert is another one.
A simple way to build awareness and concentration is to count your breaths. Close your eyes and notice yourself breathing in and breathing out. Start to count each cycle of breath as you observe yourself breathing. Can you get up to 10? It’s not unusual for people to get lost in thought long before that. As soon as you recognize you’ve lost count, smile at yourself and start over.
With eyes closed, simply keep your breath “company.” Watch it go in and out. Notice when it speeds up, when you take a bigger breath, or a shallow one. When your mind wanders away from breath, bring it back. This form of breath meditation is different than pranayama, yogic breathing practices that use directed breath to channel energy. The focus here is on staying present to observation.
Sometimes thinking and emotional activity has such a strong gravitation force it can be difficult to pull away. Body scan can be a quick way to become mindful.
One form of body scan is to notice what parts of your body are in contact with something. The contact your seat is making with the cushion or chair. The feeling of your hands on your lap or folded.
Another form is to notice where there is “noise” – tension or pain is an easy draw for attention, so bringing your attention to it gently, without fighting with it or trying to change it.
Finally you can scan your body from head to toe. Let your attention first dwell on, then move downward. What do you notice happening at the crown of your head? The muscles in your face, your forehead, around your eyes, your jaw, around your mouth; your neck, shoulders, etc.
Eating & Drinking Meditation
To demonstrate how mindfulness is something that can be practiced anywhere, anytime — and at its best when integrated into daily life — try this:
While you are at a café having coffee or seated at a meal, close your eyes as you take the next sip or bite. Let’s say you are eating an orange. As you bring the orange closer to your mouth, what sensations or changes do you notice, even before you take a bite of it? What is the sensation of taking a bite? You notice taste. Where is the taste? Is it in the front of your palate, back or side? The texture? Temperature? Meanwhile what is happening in your mind? Is it pushing you to take the next bite, or already thinking about what you will do after your meal? By slowing down an experience you discover its complexity and enjoy its richness at the same time.
Standing in Line Meditation
This exercise can be challenging because of the many sources of sensory, mental, and interpersonal input. However it is a particularly valuable one because it’s a great way to put “wasted” time to good use, and supports mindfulness while living your life.
You can start by putting away the phone, closing your eyes for a moment and giving yourself a deep breath to support the exercise. With eyes open or closed, what do you notice about your posture? Is your weight mostly on one foot; or are you leaning on something? What sensations are in your body? Are there muscle groups that are tense? What is your breathing like? What is the tone of your emotions? Are you bored, impatient, or simply far away, disconnected? If so what is it like to bring your presence back to the here and now? What can be noticed that you didn’t notice before? What kind of flooring are you standing on? Who is around you? What shifts do you notice in yourself as you wait? If you like the idea of this meditation but find it challenging, one way you could support the practice is to break it down by recording your observations as you go.
Loving Kindness and Compassion
This is a very specific and scripted meditation that systematically cultivates concentration and the positive forces of love, kindness, and compassion. In the Theravadan Buddhist tradition they are called Metta and Karuna meditations.
You start by thinking of someone who is easy to love or care for, and repeat phrases such as “May you be happy,” or “May you be free of suffering.” You include yourself, and move onto people you are either indifferent to, or you may be in conflict with. It is a very powerful meditation. In terms of its effect on the mind it has some similarities with the positive psychology movement and the power of cultivating gratitude and appreciation. As it turns out, the mind is quite powerful and can be directed to cultivate positive forces just as effectively as it can continuously grind out resentment, anger, disappointment, etc. To get started on this you could simply make the focus of mindfulness a phrase such as “May I be well and happy,” and while you are thinking this phrase do your best to mean it.
Formula for Mindfulness Meditation Exercises
As you can see from these examples, no matter what you are doing there are common elements to cultivating mindfulness. Here are some of them:
- Coming into presence. We spend most of our day distracted or lost in thought. Bringing conscious awareness to the here and now.
- Noticing sensations and perceptions. Sensations and perceptions are something that only happen in the present moment. Staying close to them is the best way to support mindfulness.
- Being inquisitive. The more inquisitive you are about what is happening, the more there is to notice.
- Being patient. Patience, and its sibling Perseverance, are the qualities most conducive to progress.
- Reducing reactivity and interference. As you meditate, notice more than alter what you observe. For example, take the Counting Breaths meditation. You start counting, then quickly realize you had stopped counting and were lost in thinking. Rather than getting impatient with yourself, berating yourself, feeling exasperated or judgmental, the practice is to simply to bring your attention back to now, and starting over. In the time it takes you to react to what is not happening, you are losing the opportunity to simply practice. Or you may find yourself revising or improving ways to count your breath. This too can be a form of reactivity. For the sake of cultivating mindfulness, just try to keep it simple.
- Kind attitude. Joseph Goldstein once said that the path of mindfulness without ethical behavior was the equivalent of rowing a boat while tethered to a dock. Similarly, mindfulness without kindness misses the point. Although it is often the natural (and eventual) consequence of practice, it helps to realize from the beginning that a kind and friendly attitude toward oneself is part of what you are aiming for. If concentration is like movement in a dance, kindness is the music.
How do therapists incorporate mindfulness into their practice?
Some practitioners integrate a mindfulness orientation to their work because of their personal exposure to and familiarity and attraction to mindfulness. This may take the form of moderate to intense mindfulness classes and retreats. Some may train and certify in highly structured mindfulness-based approaches or programs, such as Mindfulness-based Stress Reduction (MBSR) and Mindfulness-based Cognitive Therapy (MBCT).
At the same time, partly due to the popularity of mindfulness and partly to the fact that there is something universally accessible about the benefits of it, mindfulness-based therapies are the fastest growing area of practice. Many therapists are naturally drawn to commonalities within the humanistic, empathetic, yet neutral elements of their training with mindfulness. A small but growing number of clinicians devote themselves to an in-depth understanding of these commonalities, while “walking the talk” by integrating into their lives the foundation principles underlying mindfulness, namely of ethics, compassion, and practice.
How did Dr. Wu integrate mindfulness into her work?
My current mindfulness and psychotherapy practice represents the dovetailing of different strands of professional training and personal interest. As a trained psychoanalyst, attention, awareness, nonjudgment, open curiosity, and helping patients tolerate expanding realms of affect — were the focus of decades of training and thousands of hours of practice. (I still feel like a beginner.)
My lifelong personal interest in spiritual practices of different traditions led me to the Vippassana School (Buddhist, Theravadan) of insight meditation in the early 1990s, and in 2009 I was invited to join a 3-year training program to develop teachers and leaders in that tradition. Mindfulness and psychotherapy share common processes so in one aspect how I integrate them is seamless, such as helping patients be curious, helping them to be open to experience, and so forth. At times I find that introducing specific mindfulness exercises or homework is relevant to a particular patient’s needs and wishes. I invite the patient’s collaboration in determining how best to make the process helpful every step of the way.
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The Science of Meditation & Mindfulness: Is there any science behind mindfulness?
The science of mindfulness is an exciting development in neuroscientific research. On this page are posted brief synopses of key studies in the field, followed by a brief summary.
Scientific support of meditation and mindfulness
The net effect of these studies suggest that first, there are clear and measurable neurophysiological indicators associated with meditation. Some of these studies have measured actual brain tissue growth associated with meditation, while others have measured sustained changes in levels of functional activity. Studies comparing meditators have demonstrated scientifically significant differences in the brain in the very areas associated with mindfulness skills, such as areas associated with greater self-control and inhibition of impulses, improved regulation of emotion and decrease of reactivity, decrease in negative emotions and increase in positive emotions.
But they have also demonstrated unexpected differences such as the slowing of age-related cognitive decline including better memory, perceptual speed, decision-making, executive functions, and learning ability in meditators compared to non-meditators.
Scientific experiments (randomized, controlled) have also shown improvement either in disease outcome (such as improved immune function) or behavior related to outcome – in conditions such as asthma, chronic pain, cancer, diabetes, chronic fatigue, smoking, insomnia, irritable bowel, addictions and eating disorders.
Areas of the brain that have been demonstrated to change with meditation include positive change in the left prefrontal cortex (LPFC) (happy emotions, energy and motivation), anterior cingulate cortex (ACC) (attention, motivation, and emotion regulation), hippocampus (emotional regulation, learning and memory), anterior insulae and sensory motor cortex (integrating emotional processes, tracking visceral and gut sensations in the service of improved social intelligence and empathy). Beneficial negative changes have been found as in the decreased activity of the right prefrontal cortex (RPFC) (associated with depression and anxiety), amygdala (fear responsive, reactivity), anterior insulae (decreased size associated with significant pathologies including clinical depression, severe anxiety, increased stress and PTSD.
Functional Brain Mapping of the Relaxation Response and Meditation
Sara Lazar et al. reported in 20001 a strongly significant finding of brain activation (up to p < 10-7) in numerous regions of the brain in experienced meditators, including structures involved in attention (frontal & parietal cortex), emotional arousal and regulation (anterior cingulate, amygdala, midbrain & hypothalamus). In other words meditation consistently activates distinct regions in the brain.
Measurable (statistically significant) difference in brain activity and growth of brain tissue in experienced meditators in the areas of the brain that control attention (frontal and parietal cortex), emotional regulation and arousal (reactivity) (anterior cingulate, amygdala (reduction of tissue in this stress-related brain center), midbrain and hypothalamus)
Alterations in Brain and Immune Function Produced by Mindfulness Meditation
An article by neuroscientist Richard Davidson et al. (2003)2 associated significantly stronger immune responsein meditators to flu vaccine (compared to non-meditators) and anterior left brain activation. The subjects were participants in an 8-week program on meditation. Immune response was measured by antibody titer to flu vaccine. This study points to the likelihood that the effects of meditation reach deep into the neurophysiological systems of the human body in a positive way. This study also measured brain electrical activity, and the authors suggest that anterior left brain activation is suggestive of stronger capacity to adapt to negative emotion and the generation of positive emotion.
Measurable (statistically significant) stronger immune response in meditators to flu vaccine, measured by the amount of antibody
Meditation Experience is Associated with Increased Cortical Thickness
Sara Lazar et al. reported in 20053 that meditation correlated with an increased cortical thickness (right hemisphere) offsetting age-related frontal cortical thinning (loss of brain cells). Specifically mentioned were parts of the brain associated with meditation such as attention & bodily awareness (prefrontal cortex and insula). What is important about this study is the scientific demonstration that meditation actually causes the structure of the brain to change, in areas that psychologists now know to be extremely important in emotional regulation and social processing.
Meditation actually causes the structure of the brain to change. Measured pre- and post- meditation training, areas of the brain where cortical tissue thickened were those associated with attention, bodily awareness, emotional regulation, and social processing (right hemisphere, prefrontal cortex and insula)
In 2005, at the Mind Life Conference at Johns Hopkins University, Wolf Singer (Max Planck Institute for Brain Research) presents to the Dalai Lama his research on meditation and the brain. Given the highly distributed nature of the brain system, a key function of the brain is to organize scattered or distributed aspects of a given event or percept, drawing upon different regions in the brain that process the features of that event or percept. Singer suggests that when such binding or organization is taking place neurons fire in a synchronous, oscillatory pattern that is characteristic of attentiveness. Meditation has been found to be associated with this type of brain activity that is associated with mental coherence and higher levels of brain activity and efficiency.
Meditation is associated with brain activity we could call coherence and organization, activity that allows the brain to operate at its highest level and most efficiently.
Long-Term Meditation is Associated with Increased Gray Matter Density in the Brain Stem
Vestergaard-Poulsen et. Al. reported in 20094 that they found changes in the structure of the lower brainstem, by density (versus volume) as well as in the superior and inferior gyrus. Combined with previous studies that demonstrated that meditation improved vagal tone (heart rate, blood pressure) and improved immune response, their study added another piece of the puzzle to a complex brain / immune system / stress response / emotional processing. In other words, meditation increasingly looks like it taps into deep and powerful pathways in the brain, that make a person more likely to be able to resist stress and function alertly.
Meditation taps into deep and powerful pathways in the brain such as those associated with hardiness and resilience, stress resistance, and immune competence, including improving vagal tone (heart rate and blood pressure)
Mindfulness Practice Leads to Increases in Regional Brain Gray Matter Density.
Hölzel et al. demonstrated in 20115 long-term changes to the brain gray matter (cells & synapses) for people participating in a Mindfulness-Based Stress Reduction (MBSR) course, specifically in the hippocampus as well as other brain structures including cerebellar. Like Davidson’s (2003) study these findings suggest that even a little bit of mindfulness practice can go a long way. They also demonstrate a pattern of expanding regions of brain involvement relevant to mindfulness activity.