Mindfulness

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Mindfulness meditation is derived from Tibetan Buddhism and is often referred to as "Insight" or "Vipassana" Meditation. It is practiced as a secular therapeutic technique to deepen awareness of the present moment, develop focused attention, and to cultivate positive feelings of compassion and joy.

Individuals typically engage in mindfulness meditation for 10 - 45 minutes during a formal sitting practice as well as at other times throughout regular daily activity. Jon Kabat-Zinn developed Mindfulness-Based Stress Reduction (MBSR) to teach mindfulness to professionals and patients in medical settings.

Research on MBSR

Research using RCT designs to explore mindfulness effects on different clinical conditions has only recently begun. One NIH funded trial is underway to explore its effect on hypertension. A variant of MBSR, Mindfulness-Based Cognitive Therapy (MBCT), has good evidence (two large scale RCTs) to support its use with patients who have suffered from several episodes of major depression. A considerable body of research on MBSR has accumulated in the last 15 years, most of which have been conducted with clinical populations. A meta-anlysis on MBSR studies has been shown a moderate effect size for reducing anxiety in a variety of patient populations and relieving pain from physical symptoms.

Instruction in MBSR

Participants can learn mindfulness by attending classes or courses held in their local community. The courses usually involve four to eight group sessions held weekly for one and one half (1 1/2) to two hours. Courses that teach MBSR or MBCT instruct participants in a number of techniques to help them progressively cultivate an uncritical attitude to habitual, problematic patterns of thinking, and feeling, and to increase moment-to-moment awareness. The techniques use the breath as a point of focus to quiet the mind, and also include a body scan, as well as yoga and other meditative techniques tot help isolate and sense experiences.

Participants can also learn to practice mindfulness through individual mentorship with a teacher or the use of guided meditation recordings. While teacher-led courses often include meditation CDs to help participants maintain regular practice, many people can buy CDs and learn to practice without any formal instruction by a teacher. To guide you or your patients in mindfulness meditation, you can use the following sound file. You may listen by download to the 13-minute audiofile.

Practicing Mindfulness Meditation

Individuals practice mindfulness meditation in a formal sitting position typically for 10 - 60 minutes a day. The number of required minutes of practice time varies according to the teacher or program. A quiet environment without distraction is essential to beginning practice. Emphasis is also on the regularity of practice and engagement in mindfulness during regular daily activity.

Treatment Issues in Mindfulness

Cost

• No set fee is established for learning MBSR or mindfulness techniques. If participants attend a week-long residential training program to learn the practice, the cost can be almost as expensive as TM. If participants get started with a series classes offered at their local community hospital or recreation center, the fee can be as low as $60. Meditation centers affiliated with different spiritual traditions or teachers may teach mindfulness on a donation basis. There is no insurance reimbursement for mindfulness meditation or MBSR. MBCT may be reimbursed if conducted by a qualified mental health professional or healthcare provider.

Professional Credentials

• Southeastern MIchigan is rich with mindfulness teachers and meditation centers. No uniform national training program exists for teaching mindfulness. Some mindfulness teachers practice under the guidance of a master teacher and do not teach others until their teacher feels they are ready. Others begin to teach after more limited involvement in meditation courses. The MBSR program has a certifying process for teacher training that involves several courses and apprenticeship requirements. Some mindfulness meditation programs and centers are now starting to develop formal teacher training programs.

Local Access

• At the University of Michigan Health System (UMHS), classes are offered through Preventive Cardiology and Chelsea Health and Wellness Center. The local community bookstore, Crazy Wisdom provides a calendar of meditation classes offered by community teachers, some of whom teach mindfulness. In the resource section that follows at the end of this unit, you can find and print a list of reputable local community mindfulness meditation centers for your patients.

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