Managing Stress through Mindfulness Meditation

What Is Mindfulness Meditation?

Distinction between ‘mindfulness’ and ‘mindfulness meditation (MM)’

Mindfulness is paying attention to the present moment

MM also includes a direct, experiential understanding/ insight into the nature of mental activity and mental events

Although present in all spiritual traditions, MM as it is being taught in the West draws it’s inspiration and technique from Buddhism

MM was taught as a powerful, gradual method of self-knowledge and self-mastery through disciplined observation of mental processes

MM includes two main components: tranquility meditation (TM) and insight meditation (IM)

TM: calming the mind, usually by maintaining awareness of the breathe and resisting focusing on the contents of mental activity

IM: understanding the ‘nature’ or main characteristics of mental events and mental activities and our relationship to them

core skill defining mindfulness is the capacity to respond to mental events with an attitude of non-judgmental, accepting, present-moment, awareness (Segal, Williams &

Teasdale, 2002) “…dispassionate, non-evaluative, and

sustained moment-to-moment awareness of perceptible mental states and processes” (Grossman et al., 2004)

Mindfulness-based stress reduction (MBSR), usually delivered in 8 weekly sessions, has emerged as one of the better known clinical applications of MM (Kabat-Zinn, 1990)

MBSR has been shown to significantly benefit individuals with a diverse set of conditions when included as an adjunctive intervention, including :

chronic pain (Kabat-Zinn et al., 1987),

cancer (Speca et al., 2000), anxiety disorders (Kabat-Zinn et al., 1992),

eating disorders (Kristeller & Hallett, 1999)

fibromyalgia (Goldenberg et al., 1994)

relapse to depression (Segal et al., 2002).

Psoriasis (Kabat-Zinn et al., 1998)

Stress (Williams etal., 2001)

addictive behavior (Marlatt, 2002)

How Does Mindfulness Help?

Relaxation?Desensitization?Distraction?Increased frustration tolerance?Extinction?Acceptance?Insight into nature of mental activity?

Spiritual teachings that form the basis for MBSR and other MM interventions stress all of these pathways but especially the last one: insight

Such insight reflects the experientially-based conviction that mental events are impermanent, lack any essential / objective existence, and can exacerbate suffering and distress

By comparison, lack of insight attributes a substantiality and power to mental activity that it, by nature, does not possess

“Pain is unavoidable; Suffering is optional”MM addresses the suffering or distress associated

with mental and physical illness by skilful training in this insight

most modern MM interventions include extensive practice in MM, breathing exercises, yoga/ body awareness, compassion training and other elements

Although research to date is generally supportive, it is not yet definitive

Research is being directed towards measuring M, evaluating which components of MM are most effective, understanding the biology/ neuroscience of MM, and the mechanism by which it benefits

What Happens During MM?

Although evidence for the efficacy of MM is growing, very little is known about what is happening while people meditate

Without greater understanding of what is actually happening ‘within the mind’ it is very difficult to convincingly attribute any benefits of MM to actual MM

Our study was designed to obtain some evidence related to this question

Study of Mindfulness Process

Healthy sample of 17 undergraduate students Received course credit for participatingMost had previous MM experienceAsked to meditate 20’ daily for 8 weeksRecorded their subjective experiences of MM on

a daily basisProvided with weekly instruction by TTPre/post assessment of depression, anxiety,

somatic stress, mindfulness skills

Daily diary rated the frequency* of the following aspects of MM:

Feelings of tranquility and calm Ability to remain present-focused Ability to remain non-distractible Distancing from mental activity Nonjudgmental attitude towards mental events Restlessness and agitation Maintaining attention on the breathe*ranging from ‘none of the time’ to ‘all of the time’ on a 6-point scale

Weekly instruction encouraged: attention on breath; noting mental activity but neither ‘avoiding’ or

‘holding’ on to them; permitting mental events to naturally arise and

subside without interference attitude of curious, benign observation similar to

the experience of ‘watching clouds cross the sky’

Results

14 females; 3 malesMean Age in early 20’sFrequency of meditation: 79% of days or

44/56 (ranged from 50% to 100% compliance)

Length of daily meditation: 17 min/day or 1.6 hrs. per week (~13 hours in total)

Lower anxiety scores post-8 weeks were significantly associated with higher ratings of the following towards mental activity:

nonjudgmental/accepting attitude (~r=.-75)non-distractibility (~r =-. 58)present-focus (~r=-.60)achieving tranquility (~r = -.50)

Lower depression scores post-8 weeks was significantly associated with higher rating of:

nonjudgmental/accepting attitude (~r=.70)

Lower somatic symptom scores post-8 weeks was significantly associated with:

amount of time spent in MM (~r=.65)

Significant improvements in ratings of behavioral impulsivity, social relationships and role effectiveness also found

Subjects with > 11 hrs of MM during the study had significantly higher ratings on measures of present-focus and non-distractibility than those with <11 hrs of MM

The more time spent in MM per day (which

ranged from 9 - 40 minutes with an avg of 17 minutes), the higher the rating for maintaining:

present-focus (r=.80), non-distractibility (r =.78), tranquility (r = .73) and non-restlessness (r = .64) at the end of the

8-weeks

Summary and Conclusions

MM is increasingly being shown to be an effective adjunctive intervention for the alleviation of mental and physical illness-associated stress and suffering

While we know little about what occurs while people practice MM, this study showed that a brief, 8-week program with healthy undergraduates produced measurable benefits with only ~17 minutes of MM/ day

Specifically, skill in maintaining present-focus, a non-judgmental attitude and tranquility was associated with lower frequency in negative moods such as anxiety and depression

reduced physical symptoms of stress was most associated with time spent in MM

Since more time meditating was associated with stronger effects it is likely that practicing MM for about an hour/ day (which is commonly recommended) would yield correspondingly stronger effects, especially in populations who are in significant clinical distress

However, even in non-clinical populations, improvements were evident with as little as 17 min/day over a two-month period

In conclusion, MM is an ancient but novel intervention that is showing potential to help reduce stress and suffering and to also increase self-understanding if practiced regularly and properly

MM Instructions

maintain erect but comfortable sitting posture maintain attention on rhythym of breathing when distracted by any mental activity, note/label

distraction and return attention to breathing do not force the mind neither to think or to not think neither encourage thought nor block it permit thoughts to arise, briefly abide, and subside observe your mind dispassionately but alertly if thoughts come, let them come; if they go, let them go;

if they stay, let them stay