Mindfulness: the current literature

There's so many informative sources, especially in the academic and scientific realms on this wonderful topic of mindfulness. And it is so interesting to think about how much it has changed therapies and even the entire field of psychology.

The literature that I have looked at thus far mainly consists of scientific studies. So many of them confirm the effectiveness of mindfulness training in treating various emotional and mental disorders (especially depression and anxiety) in different clinical settings (cognitive behavioral therapy, exposure therapy, psychotherapy, etc). But they all raise further intriguing questions and set the stage for more research.

Mindfulness means being detached from your thoughts instead of overengaging and becoming distressed by them. It means accepting them, no matter how negative or severe. It means being aware and focused on the present. It is a technique that has been used for 2500 years by Buddhists to quiet the mind. It has also been used in western cultures to successfully reduce anxiety, anger, depression, and other such maladaptive states.

Only recently (as in, within the last 20 years), has it become a topic of scientific scrutiny in the United States and been applied to therapeutic interventions.

For such a relatively young field, the literature is abundant. Individuals who undergo mindfulness-based interventions improve significantly. Their ratings of mindfulness increase (this is measured by many scales that determine how attached to one's thoughts an individual is, how much distressing thoughts negatively affect them emotionally, self-acceptance, and awareness). They experience a reduction in depressive symptoms. The difference between their ideal self model (the person they want to be) and their real self is smaller, so they are more content with their real selves and percieve a smaller gap between who they are and who they wish to become. Mindfulness-based therapies also reduce rumination and avoidance, which are maladaptive coping strategies, since mindfulness is an adaptive technique for dealing with distressing cognitions. Rumination means thinking a lot about these thoughts, how they are self-relevant, their causes and possible consequences, and so on. These thoughts only lead to more distress and depression. Avoidance means distracting oneself from these thoughts. But actively trying to push thoughts out of your mind can have a drastic rebound effect, leading to rumination.

Significantly, the effects of mindfulness-based interventions are enduring. Mindfulness is an important addition to existing therapies because it is a skill that, if practiced consistently, can last a lifetime. Therapies such as cognitive behavior therapy (CBT) are highly effective in treating depression, but most people who are treated for depression experience at least one more episode afterward. Teaching recovered patients mindfulness is a way to maintain the effects of therapy in order to prevent relapse. This is even effective for formerly-depressed patients who had exhibited suicidal behavior, attempts, or ideation. It is far less expensive than long-term therapy and much safer than antidepressants or other drugs that only suppress the symptoms without getting at the underlying problems.

So we have all this evidence strongly suggesting that there really is something to this mindfulness thing. But it's time to go deeper. No one has really proven... yet... that it is the MINDFULNESS aspect of therapy producing all of these wonderful results. We also don't know how exactly mindfulness works.

Although it hasn't been conclusively proven yet, mindfulness seems a very beneficial and effective addition to therapy.  The study of mindfulness is still very young, but the results are promising. We know that mindfulness-based therapies work.  Now it is time to research further into exactly WHY and HOW it works, and what specific contribitions mindfulness training makes.

The implications of mindfulness-based therapy

Hello Fellow bloggers!

It turns out my previous thesis was not so good. So here's my working thesis as of now: the addition of mindfulness training to therapeutic interventions is an improvement to therapies because it prolongs the effects of the therapy.

Mindfulness is a skill. It lasts for as long as you continue to practice it.  If you go to therapy to treat anxiety or depression, for example, and you learn the mindfulness technique, then you can keep using this technique after therapy to make sure that the depression or anxiety doesn't come back later, which it usually does when you only do therapy alone.

So what are the implications?

If mindfulness-based therapies really are effective in the long term (which research to date suggests is true, but a lot more will need to be done to confirm this), then the therapies should be more brief and patients should not have to return to therapy after the first intervention because of recurring symptoms.  Therefore, it is much more cost efficient than long-term psychotherapies or therapies that only treat the immediate symptoms but do not protect against relapse.  This might mean that more people will be willing to seek therapy, especially people suffering from depression.  Depression is the most common mental disorder and the most untreated.  Depressed people do not seek professional help for various reasons.  One important reason is that they do not have the energy to go to a therapist and stick to a treatment plan.  They also may feel pessimistic about the effectiveness of therapy, especially considering the fact that most people who are treated for depression experience at least one more episode after therapy.  But if they can undergo a therapy that lasts only around 8 weeks and whose benefits can be maintained for a long time, possibly even for life, then depressed individuals may feel more motivated to try it.  This therapy would also appeal to those who are hesitant to seek professional help for financial reasons, since it is a short therapy with lasting effects.

This may also replace antidepressants and other medications for some people.  Pharmacotherapy only suppresses the symptoms, and it only works while you are taking the pills.  Mindfulness teaches lifelong skills to deal with emotional problems and external stressors. It is also much more cost-efficient and far less dangerous.  Not everyone can take medications because of side effects or conditions that the person may have.  But mindfulness is safe and equally effective.

I don't know about you guys, but I feel like this intervention has a lot of potential.  The research on the topic is growing rapidly, but there is still much to be explored.  As an aspiring psychologist and meditation-enthusiast, I am excited about where this is going.  But I think the psychological community needs to raise awareness in the general public about this new intervention, especially now, when we have all these advertisements omvincing us that all our problems are due to chemical imbalances in the brain and becoming a pill popper will make us all balanced, like it worked for the sad little zoloft bubble.  People need to be informed on their options before they go running to their physicians for a prescription for something they saw on TV.  No matter how convincing the super-simplified animation of neurochemicals floating around the brain was.

Mind and Body... and Immunity

I want to take this opportunity to talk about an exciting young and flourishing field: neuroimmunology.

Neuroimmunology is a biochemical science that studies the interaction between the brain and immune functioning. I won't go into the scientific mumbo jumbo, but basically our thoughts influence our biochemistry, and vice versa, which also interacts with the immune system. So our thoughts actually do affect our health.

I learned about neuroimmunology while researching for my paper. I decided to write about how the field of psychology is opening up to non-western perspectives and is changing significantly by incorporating buddhist techniques into therapies. Mindfulness, which has been practiced by Buddhists for over 2,000 years, has been added to many different therapeutic interventions. It describes the ability to detach oneself from his thoughts and to observe and accept them without becoming distressed. Mindfulness changes the neurochemistry of the brain in a way that enhances immune functioning.

Mindfulness training has proven effective for treating physical and psychological illnesses. It can improve the immune functioning of cancer patients and people with HIV while also improving their mental wellbeing.

Mind Body Intelligence is a holistic approach to treating mental and physical conditions that combines mindfulness meditation, yoga, and psychotherapy. The mindfulness meditation component teaches the patient breathing techniques, detachment from and acceptance of thoughts, and Buddhist principles. MBI treats the whole person, so it is appropriate for various disorders, including mood disorders, personality disorders, substance dependence, and eating disorders. In the medical realm, it is used to alleviate the suffering of patients with chronic pain those who have a terminal illness, as well as improving their immune functioning. It also treats cardiac and pulmonary diseases and diabetes. People who undergo MBI acquire lifelong skills to deal with stress effectively, reduce anxiety, and manage pain.

As I said, this is part of my research for a paper I am writing. Here is a portion of what I have written so far that incorporates this source and also discusses mindfulness training in more detail:

Recently, literature supporting the effectiveness of mindfulness training in various settings has proliferated, evidencing the ascendance of eastern ideals in western psychology. Mindfulness training teaches the patient to observe his thoughts and accept them, no matter how unpleasant or severe (Kumar, Feldman, Hayes). Continued practice empowers the individual to detach himself from his thoughts and become less emotionally reactive to distressing thoughts or events. The mindfulness technique is effective in clinical and nonclinical settings. Within the clinical realm, it has been used to treat various disorders, including Major Depressive Disorder, Generalized Anxiety Disorder, Borderline Personality Disorder, eating disorders, Posttraumatic Stress Disorder, and substance abuse. Mindfulness has been incorporated into various types of therapies. One example is Exposure-based therapy for depression. The first phase of mindfulness training teaches the patient to focus his attention on present thoughts and respond to distress adaptively, which means observing and accepting thoughts instead of avoiding them or ruminating. In the next phase, the uses the skills learned in the first phase to respond to material that previously induced depression without becoming distressed. This is followed by exposure-based cognitive therapy. An open trial of the therapy resulted in significant increases in mindfulness, along with a reduction in avoidance and rumination behavior and absorption in distressing thoughts. It also effectively treated depression. Another intervention that incorporates mindfulness is Mind Body Intelligence Program (MBI) (Adelman). MBI is based on the assumption that the mind and body interact, so mental health is brought about by treating the entire person. It integrates aspects of Family and Systems Therapy, Psychodynamic Therapy, and CBT, along with Buddhist practices. Patients learn mindfulness meditation, which teaches breathing techniques, the ability to settle rambling thoughts and be aware of one’s body and movements, and Buddhist principles of fulfillment, compassion, and tolerance. It has been shown to improve quality of life and self-esteem, reduce pain, and enhance sleep quality.

Fascinating stuff, huh?
Stay tuned to learn more about that amazingness that is mindfulness.

Topoi

So when I was figuring out what topic to research for my writing class, I was looking for information on meditation that is somehow related to psychology. That is how I came across mindfulness-based therapies. I had never heard of this before, but I was immediately intrigued. I worried that there might not be enough on this topic to write an entire paper that would actually be worth reading, but applying the topoi method to my topic opened my eyes to a lot of possibilities that I had not considered.

Contrast
How does mindfulness therapy differ from psychoanalytic therapy? What are the pros and cons of these differences? Do mindfulness-based cognitive and behavior therapies differ significantly from traditional cognitive and behavior therapies? Does adding the mindfulness component introduce new ideas about mental illnesses and treatment?

Causes and Effects
Why has meditation become more widespread in Western culture, and what initiated its incorporation into science? There is a lot of empirical research on meditation and its benefits to mental health. Does this research precede the application of mindfulness in therapeutic approaches? Mindfulness-based therapies are short (eight sessions, each two hours) and are effective in the long-term. Does this increase the likelihood that people who do not want to commit lots of time or money to therapy will seek help? Considering it is equally effective as pharmacological interventions, will it have the effect of reducing our over-reliance on meds?

Changes
The addition of mindfulness to behavioral and cognitive therapy has caused some changes to the theories behind these interventions. Behavior theory no longer requires that symptoms, causes, and treatment be described in purely behavioral terms. It now allows for some psychological explanation and intervention. Both behavior and cognitive therapies have changed their focus from the form of negative thoughts to their function, which means they deal with thoughts that produce maladaptive effects, not negative thoughts in general. The goal of mindfulness is not to suppress maladaptive cognitions, but to learn to prevent the negative effects they have on our mood in specific situations.

A possible change associated with mindfulness-based therapy may be a greater acceptance of alternative approaches in medicine. Maybe people will be more open to using meditation instead of medicine for other illnesses as well, both mental and physical.



Well, that's as far as I've gotten with the topoi. Now I just have to figure out a thesis...

My pagey-flake

As you should have figured, based on the random bibliographies I've been posting, I am writing a research paper on some aspect of meditation and its usefulness in therapy. I created a page on pageflakes to cumulate all kinds of research in one place. If you click the link and check out my page, brilliantly entitled Paper 2, the first thing you might notice is the lovely blue sky-and-clouds theme, which is intended to create a light, happy, relaxing atmosphere. Seems appropriate for the topic, right? Now that I've put you in a good mood, hopefully you'll enjoy the actual content of the page.

My page is organized into two columns. The first flake in the first column is called BIBLIOGRAPHY FLAKE, which contains my complete bibliography plus annotations. I chose books and scholarly articles about the use of the mindfulness approach in therapies. Mindfulness means being aware of and detached from your thoughts, so you can pay attention to them but not allow them to control your feelings. It is a type of meditation that some therapists incorporate into their interventions to treat clients with mood disorders. I included sources that provide information on different aspects and applications of mindfulness-integrated therapies. Mindfulness-based Cognitive Therapy for Depression confirms the effectiveness of mindfulness training in preventing recurring episodes of depression. Mindfulness-Based Cognitive Therapy and Self-Discrepancy in Recovered Depressed Patients with a History of Depression and Suicidality assesses its ability to help people with depression or who exhibit suicidal ideation and behaviors based on the self-discrepancy theory of depression, while Letting Go: Mindfulness and Negative Automatic Thinking bases its assessment on the theory that depression is caused and maintained by negative automatic thoughts. All of these sources describe mindfulness-based cognitive therapy (MBCT), but Mindfulness and Acceptance considers behavior therapy as well. All of my sources have something unique to offer.

The next flake in the column is the rss feed to emmarlyb's delicious bookmarks, which I wrote about in my bookmarking soulmate post, followed by my own bookmarks on diigo. The next two are universal web search and universal blog search. The universal web search is already loaded with the results for "meditation psychology brain." I tried out a lot of different search terms to get the best possible results. "Meditation" by itself was definitely too general, so I tried "meditation psychology," which came up with some good things, but most were irrelevant. "meditation brain" yielded a lot of articles about the brain's activity during meditation, but not enough explained the benefits of these processes. "meditation therapy" provided some interesting articles about therapies and meditation, but very few of them actually had anything to do with the use of meditation in therapies to treat mental disorders. It turns out that searching for "meditation psychology brain" comes up with the largest number of relevant sources, which describe clinical applications of meditation and how meditation brings about positive health effects. I tried using the same search terms in the Universal Blog Search, but the results were completely useless. After trying out some different terms and combinations of terms, I ended with "mindfulness therapy."

All of the flakes in the second column are rss feeds. They come from websites where I found useful information on my topic, and they are updated regularly with new stories, articles, and so on. Some of the websites might seem irrelevant. f you are looking at it now you might be wondering, how can drug-resistant gonorrhea possibly have anything to do with meditation? And the answer is, it doesn't (at least as far as I know). But it comes from the Life section of New Scientist, which actually has some informative stories about meditation and its benefits. It's hard to find sites that emphasize the clinical use of meditation, but there are some sites on spirituality in general that are useful. My favorite is Yogic Trance, which I made a flake for, and about which I've written a profile post. Other sites that I've made flakes for are about physiology, science, or the brain. They are useful because they consider meditation from a biological perspective.

Anyway, I am hoping that organizing all these feeds and internet sources on one page will simplify my research. I have added a wide variety of sources on physiology, the brain, spirituality, etc. to get lots of different perspectives on my specific topic: mindfulness-based therapies. Hope you find that my flakes feed your interests as well!