The process of paying nonjudgmental attention to the current moment has been termed as mindfulness.
The awareness of breathing is commonly
employed as an attentional anchor to manage ruminative thought in the early
stages of mindfulness training; however mindfulness involves much more than
just noticing the breath.
It is based on Buddhist practice and has been the subject of
empirical research, with over scientific publications on mindfulness released
in the last decade. The evidence for its use in the treatment of depression and
anxiety is the strongest.
The impact sizes of mindfulness in these two illnesses have
often been reported in the moderate-strong to strong range in meta-analyses.
However, because some of the studies included in these meta-analyses failed to
account for the placebo effect, it's not unexpected that meta-analyses with
stricter inclusion criteria yield lower results.
A recent meta-analysis of randomized controlled trials of
mindfulness-based stress reduction, mindfulness-based cognitive therapy, and
other mindfulness-based interventions—each with an active control—found small
to moderate effect sizes in the treatment of depression or anxiety after eight
weeks of mindfulness training, with a reduction in effect size after three to
six months.
Although the findings are less impressive, they are
equivalent to those that would be expected from antidepressant therapy in a primary
care population without the side effects.
The National Institute for Health and Care Excellence and
the American Psychiatric Association both recommend mindfulness-based cognitive
treatment for individuals with recurrent depression, based on these findings.
Other psychiatric diseases, such as schizophrenia spectrum
disorders, eating disorders, chemical and non-chemical addiction disorders, and
sleep disorders, may benefit from mindfulness-based therapies, according to
some data.
Despite the fact that mindfulness has recently been added to
the Royal Australian and New Zealand College of Psychiatrists' practice
guidelines as a non-first-line treatment for adults with binge eating disorder,
there is arguably insufficient evidence from well-designed randomized trials to
support its use for conditions other than depression and anxiety.
Mindfulness may potentially have a role in the treatment of
somatic illnesses such as psoriasis, cancer, HIV infection, irritable bowel
syndrome, heart disease, hypertension, lung disease, diabetes mellitus, and
chronic pain, according to growing evidence.
Randomized trials show that mindfulness-based therapies,
such as mindfulness-based stress reduction and cognitive therapy, are minimally
to moderately effective in the treatment of chronic pain, with potential
applications in the treatment of pain-related diseases like fibromyalgia.
However, it's unclear if mindfulness improves patients'
capacity to manage with pain or lessens the frequency and severity of pain.
There is inadequate high-quality data to support mindfulness
for treating somatic diseases, except for chronic pain and particular pain
syndromes.
Questions that remain unanswered
As previously stated, different methodological issues
restrict the overall quality of the data on mindfulness's efficacy.
A type of "popularity impact" may impact results
in particular. Because mindfulness is becoming more popular, participants'
perceptions of getting a "fashionable" or "proven"
psychotherapy practice may affect outcomes.
Because it's very hard to blind patients from the knowledge
that they're employing mindfulness techniques, this is a challenging
confounding variable to control for.
We also need more clarity on whether positive outcomes last
for years rather than months, whether mindfulness interventions have any
negative side effects, and the validity of the traditional view among
contemplative traditions that long-term improvements in health and wellbeing
require daily mindfulness practice over many years, rather than just attending
a retreat.
In addition, data is needed to identify whether mindfulness
in general or specific interventional procedures are more useful for a
particular condition.
Numerous interventions have been developed, with significant
variation in factors such as total participant-facilitator contact hours,
including whether one-on-one contact is provided, quantity and duration of
guided mindfulness exercises, use of non-mindfulness psychotherapeutic
techniques such as psychoeducation or group discussion, inclusion of a full day
silent retreat, and emphasis on self-practitioner interaction.
Mindfulness is defined and operationalized differently in
different interventions. Recent research, for example, has concentrated on
second-generation mindfulness therapies like the eight-week Meditation
Awareness Training, which are founded on the notion that mindfulness is a
psycho-spiritual rather than just psychological skill.
It's challenging to extrapolate findings across the whole
spectrum of treatments due to significant differences in design and pedagogic
approach.
Mindfulness appears to be beneficial in improving perceptual
distance from stressful psychological and physical stimuli and in causing
functional neuro-plastic changes in the brain, according to emerging evidence.
However, mindfulness's "fashionable" reputation
among the public and the scientific community may have obscured the need to
investigate crucial methodological and practical difficulties related to its
efficacy.
You may also want to read more about Mindfulness Meditation and Healing here.
