Mindfulness

Mindfulness is certainly not an original idea from me; in fact, I’m still learning to apply its principles and techniques with my patients and with myself.  So let me give you a little background:  About 25 years ago, Jon Kabat-Zinn and some colleagues began to investigate the effects of meditation on the mind and the body.  They eventually developed an eight-week stress reduction and relaxation program (now generally called Mindfulness-Based Stress Reduction; MBSR).  Because they were working at the University of Massachusetts Medical School, they had to design their research to meet the tough standards of academic rigor.  That’s why it really drew attention when they were able to demonstrate that meditation significantly helped conditions as diverse as major depression, chronic pain, anxiety and panic, bulimia, psoriasis, fibromyalgia, mixed neurosis, mood and stress symptoms in cancer patients, and stress, anxiety, and depressive symptoms in the general population.   Later studies showed that if “normal” people practiced MBSR they experienced the kinds of brain changes that are associated with positive moods, and their immune systems were strengthened.  I would like to point out here that if a patentable drug were showing such results, the drug company owning the patent would soon become the richest in the land, and we would be seeing at least three television commercials per night touting its benefits.  But because mindfulness seems so simple, yet at the same time requires self-discipline, it’s not going to generate such heat.  Nevertheless, it is catching on, in its own quiet way.  A new psychotherapeutic approach to depression, called Mindfulness-Based Cognitive Therapy for Depression, is showing great promise.

Mindful meditation practice has been shown to affect how the brain deals with emotions, especially in the prefrontal cortex (PFC), which many brain scientists consider the actual physical location of our self-awareness.  Meditation practice results in an increase in activity in that prefrontal area, where the brain processes positive feelings and controls negative feelings, an effect that lasts even when we’re not meditating.  This area of the brain contains a set of neurons that control messages of fear and anger from the amygdala, the fear center.  It seems that the more we practice this effect, the easier it gets; we learn to control disturbing emotions just as we learn to ride a bike; after a while we don’t have to think about it, it just happens.

Buddhist monks, who practice meditation for hours daily, have been found to be the happiest people in the world, by some measures.  Richard Davidson has been studying the relative activity of the left and right lobes of that prefrontal cortex, and has found that, among the people he’s tested all over the world, more activity on the right is associated with unpleasant or depressed moods, while more activity on the left means happiness and enthusiasm.  People who consistently have greater activity on the left typically have fewer troubling moods and recover rapidly when they do.  When Davidson tested an advanced Buddhist monk, he found that he had the greatest difference between left and right lobe activity of anyone yet tested.  This observation has been repeated with other monks.  While we may not wish to completely detach ourselves from the world and meditate for hours a day, we may want to get that left prefrontal cortex more activated through some regular meditation practice.  Generally, it’s been found that the more you meditate, the more the left lobe becomes active, while the right lobe slows down.

Mindfulness-Based Stress Reduction is an intense, but brief, program.  Mindfulness, however, is a way of life.  In the program, for eight weeks you meet in a weekly two-hour group with the instructors and other group members for meditation and discussion.  There is also a daily 45-minute meditation exercise to do at home, and one full-day workshop with the staff and the group.  Kabat-Zinn’s book Full Catastrophe Living gives a thorough description of the program, and you can also buy an excellent set of guided meditation CDs from his website, www.mindfulnesstapes.com.

To me, mindfulness means deliberately trying to attain a new attitude toward your thoughts, feelings, and everyday experience—an attitude of openness, compassion, and objectivity; a deliberate effort not to be guided by old habits of thinking and behaving but to see each experience in its uniqueness.  It means seeing yourself without illusions but with love.

If mindfulness isn’t clear to you yet, consider that you’re very well acquainted with its opposite, mindlessness—the hurried, hypervigilant frame of mind that has us always rushing to cross to-dos off our lists, so pressured that we’re not able to listen or concentrate or really evaluate new information.  Instead, we quickly put it into one of our prefab stereotypes—good, bad, boring, a new emergency, or I’ll think about it later (meaning I’ll forget about it until I wake up at 4 AM with a whole list of worries I’ve repressed).  Mindfulness means being in the present moment, but slightly detached.  It means fully absorbing your thoughts, feelings, and experiences without being swept away by them.

Mindfulness also means deliberately learning to use your mind in a new way.  It’s learning to watch your mind at work, looking at yourself with compassionate curiosity.  Compassion, like a close friend, suffers with us a little but also sees the patterns that we’re normally too close to see.  Curiosity shows us that there’s really nothing to be afraid of in our own heads, but a lot we could learn.  We can then turn that same viewpoint on the world.  Practice makes us more observant and deliberate; we become more thoughtful about reacting to emotions and impulses; more curious,   ready to look beneath the surface, not so hasty about jumping to conclusions; kinder, more patient, more tolerant of others and ourselves. One of the key elements in mindfulness is detaching a little from thoughts, worries, and impulses; not  taking immediate action but expecting that if you take a step back, think, and look inside yourself, you’ll probably make a wiser decision.

Regular meditation practice is the best way to achieve a mindful state, and it’s been shown to have marvelous effects on mood, stress level, and health.  If this looks intriguing or possible to you, I urge you to give it an honest try, at least five days a week for two weeks.  If you can do that much, you will probably start to feel some benefits—more calmness, more objectivity, more open-mindedness.  But I have to warn that mindfulness meditation probably shouldn’t be attempted by the most depressed, those who are paralyzed or just exhausted getting through the day, or so overwhelmingly sad that they can’t escape their feelings.  For these particular people, meditation will seem like a huge burden with no immediate payoff, and may only lead you to focus on your misery.  Still, most depressed people are likely to feel that meditation practice is too much of a burden, and I again urge you to try.  If you can just make yourself sit down and do the first five minutes, you can probably do the rest.   Remember that your depression is largely a response to the stress that you are under, not a weakness you’re to blame for, not an illness that can only be cured with medication.  Mindfulness practice is the best cure for stress.