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What is ‘mindfulness’ and how can it help?
Mindfulness is often defined as ‘paying attention on purpose moment by moment without judging, (Full Catastrophe Living, – Jon Kabat-Zinn). This means developing the ability to pay deliberate attention to our experience from moment to moment. We learn to tune in to what is going on in our mind and body day to day without judging our experience.
Become more aware...
Becoming more aware of our thoughts, feelings and sensations may not sound like an obviously helpful thing to do, however learning to do this in a way that suspends judgement and self criticism can have surprising results. Many people report finding inner strengths and resources that help them make wiser decisions about their health and life in general.
Mindfulness can help...
Most of us find ourselves frequently ‘swept away’ by the current of thoughts and feelings, worries, pressures, responsibilities; wanting things to be different from how they are right now. This can be particularly powerful when we are faced with pain, difficulties and illness that confound our attempts to find a solution or to feel better. Feeling stuck in this way can be draining. Mindfulness can help us to work directly with the struggle we sometimes have in relating to lifes experience and in doing so can really improve the quality of our life.
What are mindfulness-based approaches?
Mindfulness-based approaches are intended to teach people practical skills that can help with physical and psychological health problems and ongoing life challenges.
Mindfulness-based approaches are an integration of ancient Buddhist practices and philosophy of mindfulness, with current psychological understanding and knowledge, they are taught in an entirely secular way, and have no religious context at all. Mindfulness-based approaches are intended to help in pragmatic, practical ways, the approaches facilitate us in realising and accessing our existing inner understanding. Mindfulness is taught through meditation skills which include bringing attention to the breath and the body during stillness and movement.
The two main approaches that have been developed in recent years are Mindfulness-Based Stress Reduction (MBSR) and Mindfulness Based Cognitive Therapy (MBCT) both of which are taught over eight 2 hr or 2.5 hr. sessions.
Mindfulness-Based Stress Reduction (MBSR)
MBSR is a group-based programme developed by Kabat-Zinn and colleagues at the University of Massachusetts Medical Centre, Centre for Mindfulness (CFM) for populations with a wide range of physical and mental health problems. It has been extensively studied since the late 1970’s. The Center for Mindfulness has been continuously delivering MBSR to patients within a large traditional American hospital for over 25 years. By 1999 over 10,000 patients had completed the programme . They have extended the teaching of MBSR into prisons, into poor inner-city areas, to medical students, and into corporate settings. MBSR has become a part of a newly recognised field of integrative medicine within behavioural medicine and general health care.
The ancient practice of mindfulness, adapted from its use as a spiritual practice, is rendered into an accessible form relevant to the difficulties faced by patients suffering from a variety of physical and psychological illnesses. The training is not tailored to any particular diagnosis. The programme thus involves intensive training in mindfulness meditation together with discussion on stress and life skills.
The evidence base on MBSR shows significant positive effect sizes with participants with chronic pain, fibromyalgia, multiple sclerosis, generalised anxiety disorder and panic, psoriasis, cancer and health care provider self care.
Mindfulness-based Cognitive Therapy (MBCT)
MBCT is an integration of MBSR with Cognitive Behavioural Therapy (CBT). It was developed and initially researched through a three site randomised control trial. It was developed to help people suffering from depression. It has been shown to help recovered recurrently depressed participants, through teaching them skills to disengage from habitual ‘automatic’ unhelpful cognitive patterns. The pattern of mind which makes people vulnerable to depressive relapse is rumination, in which the mind repetitively re-runs negative thoughts. The core skill that MBCT is teaching is to intentionally ‘shift mental gears’.
MBCT differs from conventional CBT as it does not place emphasis on changing belief in the content of thought. The focus in MBCT is on a systematic training to be more aware, moment by moment of physical sensations and of thoughts and feelings as mental events. This facilitates a ‘decentred’ relationship to thoughts and feelings from which we can see them as aspects of experience which move through our awareness and which are not necessarily reality in any given moment.
The evidence base on MBCT shows that it can halve the relapse rate in recovered patients with three or more episodes of depression. It is effective in preventing ‘autonomous’ relapses but not those provoked by stressful events.
Other targeted versions of MBCT have now been developed. e.g. MBCT for chronic fatigue syndrome and for oncology patients.
The key differences between MBSR and MBCT
Although the two programmes are broadly similar, and are often used flexibly the key ways in which MBCT differs from MBSR are as follows:
- MBCT tends to target specific conditions or vulnerabilities where as MBSR has a more generic application and is applied to stress arising from a variety of life events including physical or mental illness.
- Both MBSR and MBCT promote psychological insights about our experiences and difficulties and aim to develop skills to deal with these differently. MBCT puts a greater emphasis on working with and understanding the psychological and cognitive aspects of our experience.
- Both MBSR and MBCT integrate the dynamic, ‘in-the-moment-responding’ aspect of mindfulness with an understanding of the origins and maintenance factors of the unhelpful behaviours or psychopathology being dealt with. MBCT is taught within a cognitive understanding and framework.
- Both MBSR and MBCT draw on concepts and and skills from other disciplines, for example, MBSR includes teaching on everyday communication and life style, MBCT includes techniques and exercises from cognitive behavioural therapy (CBT) and includes didactic elements, which give the participants information about a particular difficulty e.g. in the case of depression participants are given information on the universal characteristics of depression to facilitate them in recognising and dealing with their relapse signatures.
Visit the official UK website of Mindfulness Based Cognitive Therapy http://mbct.co.uk/
Watch Rebecca Crane talk about the impact of stress and how mindfulness can help: