Mindfulness
[Rough Draft] I co-taught 2 courses on mindfulness with Matt Carriker, eventually I will put some of the content here
With Rev. Matt Carriker co-taught a 6 week course (6 1.5 hour classes) on Mindfulness at Brandeis...more descriptions later. The key innovation was to have each student personalize and customize their practice after going over the many different ways of being mindful.
Co-taught a 2 part series with Rev. Matt Carriker at Waltham library on mindfulness...more descriptions to come.
Here is a playlist of mindfulness videos that I have made:
https://youtube.com/playlist?list=PLTkUNrWhI352GTRO8kl62oV6XApAaveqk
The Science of Mindfulness
Vivekanand Pandey Vimal
Introduction
I was honored when Matt asked me to write a small article on the Science of Mindfulness. This is still a rough draft and I have only read through a few review articles. My goal is to iterate this summary and add more literature and depth. I will appreciate any feedback on how to improve and clarify the content and also what sorts of science related questions you would like me to address further.
What is Mindfulness?
One of my friends once said to me, “Oh, isnt mindfulness when you cross your legs and say ‘homm homm’, it is so pretentious”. To address this, Matt has shared the ‘Tree of Contemplative Practices’ which is one visualization of the different methods to practice mindfulness. Mindfulness can include sitting and concentrating on one’s breath but it can also include listening to music, walking, drawing...almost anything. This is because mindfulness is a state of mind and each person will have a slightly different path that will allow them to reach it. There are 3 characteristics that define this state of mind and unify all of the different methods of practice.
1. Be in the present moment
2. When thoughts inevitably bubble up, nonjudgmentally acknowledge them and gently push them away and return back into the present moment. It is important not to become angry at yourself for feeling distracted.
3. A spiritual feeling of connection, love, and dissolving one’s self into the larger universe. For some people this allows them to connect to their religion, however religion is not a requirement.
For the most part, the scientific community, when conducting research on mindfulness, focuses only on the first 2 characteristics. However, the final characteristic has been an intrinsic part of mindfulness across its history of thousands of years. A final characteristic is that mindfulness is a practice, and is meant to be developed over years and integrated into your life.
Is there any scientific proof that mindfulness has benefits?
The scientific community’s focus on mindfulness is only a few decades old, however recently there has been an explosion in the number of published articles. Many of these research articles have significant limitations (see the next question). Nevertheless, there are a few findings that have been confirmed by different independent groups of researchers across relatively large participant groups. These findings report that mindfulness can help in the treatment of depression, anxiety, addiction, chronic stress, immunity (by reducing stress) and even chronic pain. Because these research findings have been compelling enough, many hospitals use mindfulness in the clinical setting.
To give you an idea of what clinical mindfulness looks like, I will give a quick overview of MGH’s ‘Stress Management and Resiliency Training’, which is a 8 week program that includes mindfulness in addition to other practices.
- Week 1: Stillness Meditation, Breath Awareness
- Week 2: Body Scan, Discussions on Sleep, Identifying Emotions and Positive Physical Sensations
- Week 3: Awareness Meditation, Mindful Eating, Stress Warning Signals, Social Support
- Week 4: Yoga, Negative Automatic Thoughts, Thought Distortions, Coping Logs, List of Pleasant Behaviors, Walking Meditation
- Week 5: Insight Imagery, Creating Adaptive Perspectives, Achieving Acceptance, Healthy Eating, Joyful Place Imagery
- Week 6: Contemplation, Comparing Optimism and Pessimism, Good and Bad Routine, Promoting Physical Activity
- Week 7: Love and Kindness Meditation, Creative Expression, Empathy
- Week 8: Idealizing Self, Humor and Coping, Laughter, Tips for Staying Resilient
What are the limitations of mindfulness research?
To begin with, the effectiveness of mindfulness is not, on average, any better than other treatments. One reason for this is that there are huge individual differences on how people respond to mindfulness. For some, it can have profound effects whereas for others it may not be effective. Therefore, it is important to emphasize that mindfulness is not a cure-all, and for many people, it should be paired with other treatments. I should also note, that while mindfulness does not have side effects like medication, there are rare reports that mindfulness can lead to negative consequences, because they may open up painful memories and trauma. Some argue that this is how a person heals, by encountering and resolving these traumas.
The limitations in the research primarily come from very small sample sizes. Many will only have a few dozen participants. Even for those that are able to run a few hundred participants, one has to wonder whether it is truly representative of the larger population. The second major limitation is that these studies quantify improvement only over short time scales. So, for example, the most common method is to quantify something beforehand (e.g. brain scan, survey of mental state), administer mindfulness over a few weeks and then follow up with the same quantification afterwards. The problem with this is that mindfulness is a practice that needs to be established over a long time. For example, a diet that works to reduce weight only for a few weeks will be considered ineffective overall. Therefore, the best experiments would be to follow these individuals across years (and getting funding for that is very difficult). The other problem that I find, which is common in other fields of science as well, is that there is very little focus on characterizing individual differences, which I think will be critical for obtaining a better comprehension of why mindfulness works.
Why does Mindfulness work? What are the mechanisms behind it?
While there is compelling clinical evidence that mindfulness works, there is no conclusive explanation for why it works. One reason for this is that the science of mindfulness is still in its infancy. As we are able to run more people in experiments and understand the individual differences, a clearer picture will emerge. For now, I will present two ideas in the literature that I find appealing.
Idea 1: Mindfulness can help reduce associations linked with bad habits and rumination
One idea in neuroscience is when different parts of the brain fire together, they wire together. For example, if you smoke when near a favorite tree, you will build an association between smoking and that tree. Even after successfully quitting smoking, the next time you see the tree it will increase your desire to smoke. Similarly, you may have a chain of thoughts that form to help you solve a problem (eg you keep getting bad grades). Initially you will loop that chain of thoughts to find a good solution, and with each loop, you will strengthen the connection between those thoughts. Eventually, if there is no clear solution, those thoughts may become negative loops that can be triggered very easily. These negative loops are called rumination and they are related to higher levels of anxiety and depression. One question is, “how can we break these loops?” The idea behind mindfulness is that we can remain in the present moment and whenever a negative loop begins, we can acknowledge it, and gently push it away. With years of practice, the ability to gently push away a loop becomes easier and a person can spend greater time in the present moment.
Idea 2: Mindfulness can help reduce the secondary stress response
Once we are injured, either physically, mentally, spiritually or emotionally, we have to undergo a healing process. Sometimes, worse than the initial injury, is the secondary stress response, especially if the stress becomes chronic. It has been established that chronic stress can lead to a variety very negative consequences. For example, if you have a significant hip injury that inhibits your mobility and changes the way you used to do things, understandably you may become frustrated which may lead to social isolation which may lead to depression. As mentioned above, mindfulness can help reduce rumination and looping negative thoughts, which can reduce stress. Often, mindfulness doesn’t provide you with a ‘cure’ to completely eliminate chronic pain or depression, but rather it can allow you to actively acknowledge your present state and obtain a feeling of balance in a new state of normalcy.
References
1. Creswell, J. David. "Mindfulness interventions." Annual review of psychology 68 (2017): 491-516.
2. Tang, Yi-Yuan, Britta K. Hölzel, and Michael I. Posner. "The neuroscience of mindfulness meditation." Nature Reviews Neuroscience 16.4 (2015): 213-225.
3. Baer, Ruth A. "Mindfulness training as a clinical intervention: A conceptual and empirical review." Clinical psychology: Science and practice 10.2 (2003): 125-143.
4. Jain, Shamini, et al. "A randomized controlled trial of mindfulness meditation versus relaxation training: effects on distress, positive states of mind, rumination, and distraction." Annals of behavioral medicine 33.1 (2007): 11-21.