Managing stress through mindfullness meditation

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					Managing Stress through Mindfulness Meditation
Linda Nguyen, BSc
Faculty of Nursing, University of Toronto

Tony Toneatto, PhD
Centre for Addiction and Mental Health

What Is Mindfulness Meditation?
Distinction between „mindfulness‟ and

„mindfulness meditation (MM)‟ Mindfulness is paying attention to the present moment MM also includes a direct, experiential understanding/ insight into the nature of mental activity and mental events

Although present in all spiritual traditions,

MM as it is being taught in the West draws it‟s inspiration and technique from Buddhism MM was taught as a powerful, gradual method of self-knowledge and self-mastery through disciplined observation of mental processes

 MM includes two main components: tranquility

meditation (TM) and insight meditation (IM)  TM: calming the mind, usually by maintaining awareness of the breathe and resisting focusing on the contents of mental activity  IM: understanding the „nature‟ or main characteristics of mental events and mental activities and our relationship to them

core skill defining mindfulness is the

capacity to respond to mental events with an attitude of non-judgmental, accepting, present-moment, awareness (Segal, Williams &
Teasdale, 2002)

“…dispassionate, non-evaluative, and

sustained moment-to-moment awareness of perceptible mental states and processes”
(Grossman et al., 2004)

 Mindfulness-based stress reduction (MBSR),

usually delivered in 8 weekly sessions, has emerged as one of the better known clinical applications of MM (Kabat-Zinn, 1990)  MBSR has been shown to significantly benefit individuals with a diverse set of conditions when included as an adjunctive intervention, including :  chronic pain (Kabat-Zinn et al., 1987),  cancer (Speca et al., 2000),  anxiety disorders (Kabat-Zinn et al., 1992),

 eating disorders (Kristeller & Hallett, 1999)

 fibromyalgia (Goldenberg et al., 1994)  relapse to depression (Segal et al., 2002).  Psoriasis (Kabat-Zinn et al., 1998)
 Stress (Williams etal., 2001)

 addictive behavior (Marlatt, 2002)

How Does Mindfulness Help?

Desensitization? Distraction? Increased frustration tolerance?

Acceptance? Insight into nature of mental activity?

 Spiritual teachings that form the basis for MBSR

and other MM interventions stress all of these pathways but especially the last one: insight  Such insight reflects the experientially-based conviction that mental events are impermanent, lack any essential / objective existence, and can exacerbate suffering and distress  By comparison, lack of insight attributes a substantiality and power to mental activity that it, by nature, does not possess

“Pain is unavoidable; Suffering is optional”  MM addresses the suffering or distress associated with mental and physical illness by skilful training in this insight  most modern MM interventions include extensive practice in MM, breathing exercises, yoga/ body awareness, compassion training and other elements

Although research to date is generally

supportive, it is not yet definitive Research is being directed towards measuring M, evaluating which components of MM are most effective, understanding the biology/ neuroscience of MM, and the mechanism by which it benefits

What Happens During MM?
 Although evidence for the efficacy of MM is

growing, very little is known about what is happening while people meditate  Without greater understanding of what is actually happening „within the mind‟ it is very difficult to convincingly attribute any benefits of MM to actual MM  Our study was designed to obtain some evidence related to this question

Study of Mindfulness Process
 Healthy sample of 17 undergraduate students  Received course credit for participating  Most had previous MM experience  Asked to meditate 20‟ daily for 8 weeks  Recorded their subjective experiences of MM on

a daily basis  Provided with weekly instruction by TT  Pre/post assessment of depression, anxiety, somatic stress, mindfulness skills

Daily diary rated the frequency* of the

following aspects of MM:
      

Feelings of tranquility and calm Ability to remain present-focused Ability to remain non-distractible Distancing from mental activity Nonjudgmental attitude towards mental events Restlessness and agitation Maintaining attention on the breathe

*ranging from ‘none of the time’ to ‘all of the time’ on a 6-point scale

Weekly instruction encouraged:  attention on breath;  noting mental activity but neither „avoiding‟ or „holding‟ on to them;  permitting mental events to naturally arise and subside without interference  attitude of curious, benign observation similar to the experience of „watching clouds cross the sky‟

14 females; 3 males

Mean Age in early 20‟s Frequency of meditation: 79% of days or

44/56 (ranged from 50% to 100% compliance) Length of daily meditation: 17 min/day or 1.6 hrs. per week (~13 hours in total)

Lower anxiety scores post-8 weeks were

significantly associated with higher ratings of the following towards mental activity:  nonjudgmental/accepting attitude (~r=.-75)  non-distractibility (~r =-. 58)  present-focus (~r=-.60)  achieving tranquility (~r = -.50)

Lower depression scores post-8 weeks

was significantly associated with higher rating of:  nonjudgmental/accepting attitude (~r=.70)
Lower somatic symptom scores post-8

weeks was significantly associated with:  amount of time spent in MM (~r=.65)

Significant improvements in ratings of

behavioral impulsivity, social relationships and role effectiveness also found Subjects with > 11 hrs of MM during the study had significantly higher ratings on measures of present-focus and nondistractibility than those with <11 hrs of MM

The more time spent in MM per day (which
ranged from 9 - 40 minutes with an avg of 17 minutes),

the higher the rating for maintaining:  present-focus (r=.80),  non-distractibility (r =.78),  tranquility (r = .73) and  non-restlessness (r = .64) at the end of the 8-weeks

Summary and Conclusions
 MM is increasingly being shown to be an

effective adjunctive intervention for the alleviation of mental and physical illnessassociated stress and suffering  While we know little about what occurs while people practice MM, this study showed that a brief, 8-week program with healthy undergraduates produced measurable benefits with only ~17 minutes of MM/ day

Specifically, skill in maintaining present-

focus, a non-judgmental attitude and tranquility was associated with lower frequency in negative moods such as anxiety and depression  reduced physical symptoms of stress was most associated with time spent in MM

 Since more time meditating was associated with

stronger effects it is likely that practicing MM for about an hour/ day (which is commonly recommended) would yield correspondingly stronger effects, especially in populations who are in significant clinical distress  However, even in non-clinical populations, improvements were evident with as little as 17 min/day over a two-month period

In conclusion, MM is an ancient but novel

intervention that is showing potential to help reduce stress and suffering and to also increase self-understanding if practiced regularly and properly

MM Instructions
 maintain erect but comfortable sitting posture  maintain attention on rhythym of breathing  when distracted by any mental activity, note/label

distraction and return attention to breathing  do not force the mind neither to think or to not think  neither encourage thought nor block it  permit thoughts to arise, briefly abide, and subside  observe your mind dispassionately but alertly  if thoughts come, let them come; if they go, let them go; if they stay, let them stay

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