Mindfulness is one of those terms that seems self explanatory, but it really isn’t. We all have minds, so aren’t we all mindful? Probably not. The concept of mindfulness is just entering the portal of mainstream medicine. For many years, mindfulness meditation (also known as Mindfulness Based Stress Reduction, MBSR) was thought of as something akin to yoga, practiced mainly by “health nuts” who had the time to sit for hours in a trance, and mainly appealing to people who were interested in Eastern religions. It seemed “experience distant” to most people, meaning that it was interesting but not really relevant to their lives.
First of all, let’s define mindfulness. Jon Kabat-Zinn, who is credited with bringing mindfulness meditation into mainstream medicine, says that mindfulness is the awareness that arises through paying attention on purpose in the present moment nonjudgmentally. Many people think that mindfulness meditation is about clearing the mind, having a blank mind. That is not the case. Mindfulness Based Stress Reduction usually begins by sitting quietly and focusing on the breathing. As thoughts begin to intrude, and they will, they aren’t pushed away. Attention is gently brought back to the present by focusing on breathing. This back and forth between mind wandering and bringing back attention to the present occurs over and over again for most people, especially when beginning MBSR. The key is that thoughts and/or bodily sensations are not judged as good or bad; they are simply observed. For example, while engaged in MBSR, you might experience some discomfort, maybe some back pain or a sensation of hunger. You experience that sensation, but you don’t try to resist it. You don’t try to judge it as good or bad. You might be curious about it. You simply experience it. You try to develop the ability to observe your sensations objectively. Most people focus on their breathing during the meditation, but some find it easier to listen to a sound in the back ground or some quiet music. I will discuss more about the actual practice of mindfulness in the next blog.
What is the purpose of this exercise anyway? There are actually two components to bodily sensations and emotions. One component is the actual physical sensation or the emotion, while the other component is our judgment of it, how we perceive it. Do we perceive it as bad, good, pleasurable, noxious? How we perceive it is really what determines how we respond. Pain is deemed to be bad because we judge it to be. Kabat-Zinn would say that learning to stand back and observe emotions and sensations more objectively makes them more tolerable. We have a tendency, understandably, to fight what we see as negative emotions. This simply activates the sympathetic nervous system which increases blood pressure, heart rate, tenses muscles, etc. That is our fight/flight response. But though adaptive in some situations, constantly being in fight/flight mode takes its toll on the body.
Kabat-Zinn and MBSR advocates are not suggesting that we need to learn to like pain or anxiety. But practicing MBSR can keep us from being so overwhelmed by intense sensations or emotions. It’s an acceptance of our present state without letting ourselves go down the slippery slope of negativisms such as “this will ruin my day,” or “I’ll never be free of this pain.” We are so accustomed to thinking through our day as we drive to work and imagining worst case scenarios. The concept of simply focusing attention on the present is rather foreign to most of us. How much of the present do we miss by constantly focusing on the past or future?
So far, recent articles have shown that mindfulness training can reduce stress during a period of high workload on military helicopters (Meland et. al. in the International Journal of Aviation Psychology, Oct. 2015), decrease fatigue, anxiety and mood symptoms in breast cancer survivors (Carlson et. al in Psychooncology, May 2016), and decrease pain intensity, pain catastrophizing, interference of pain in daily life and depression in cancer patients (Poulin et. al., Supportive Care of Cancer, May 2016). There seems to be evidence that MBSR can help patients with addiction by modulating responses to environmental cues that instigate craving. There is even evidence that MBSR can slow progression of Alzheimer’s Disease (Quintana-Hernandez et. al. Journal of Alzheimer’s Disease, 2015) and improve some problems with memory loss. It seems to exercise the brain and keep it free of unnecessary debris.
In my next blog, I’ll explain more about the mechanics of Mindfulness Based Stress Reduction, including some tips on getting started. I’ve included a YouTube video that explains more about mindfulness based stress reduction. There are numerous YouTube videos on this topic including several by Jon Kabat-Zinn himself.