Monday, November 19, 2018

Mindfulness Meditation

Dr Ruwan M Jayatunge 

The term “mindfulness” has been used to refer to a psychological state of awareness, a practice that promotes this awareness, a mode of processing information, and a characterological trait (Brown et al., 2007; Davis & Hayes, 2011).  According to Bodhi (2000) the word mindfulness originally comes from the Pali word sati, which means having awareness, attention, and remembering   (Davis &Hayes, 2011).  Mindfulness is a psychological construct and as a form of clinical intervention. Mindfulness meditation is an open monitoring style of practice that involves ongoing, non-reactive awareness or monitoring of the present moment, of one’s phenomenological experience phrase (Burke et al., 2017).

As elucidated by Kabat-Zinn (1982) mindfulness meditation was introduced to the West in a secular and standardized clinical format about 30 years ago. The mindfulness approach is rooted in Theravada Buddhism and it was westernized by Kabat-Zinn (Moafian et al., 2017).While introducing mindfulness Kabat-Zinn modified Vipassana practice with a Zen attitude (Amihai & Kozhevnikov, 2015).

Mindfulness' is the working principle behind the effect of all meditations (Panta, 2017). According to Edmund Gustav Albrecht Husserl mindfulness is paying attention to the experience as it presents itself without any interpretational filtering. Jon Kabat-Zinn describes mindfulness as paying attention in a particular way: on purpose, in the present moment, and non-judgmentally (Kabat-Zinn, 1995). Mindfulness is the dispassionate, moment-by-moment awareness of sensations, emotions and thoughts (Marchand, 2014). Bishop (2004) specifies that mindfulness is an umbrella term that can be understood to refer to the self-regulation of attention to one's experiences in the present moment with curiosity, openness and acceptance.  The aim of mindfulness is to cultivate consistent and non-reactive present moment awareness or directed attention (Appel & Appel, 2009).

In a typical practice instruction, Kabat-Zinn suggests that participants sit comfortably with eyes closed and direct their attention to the physical sensations of breathing by simply noticing it, paying attention to it, and being aware of it. When thoughts, emotions, physical feelings, or external sounds occur, practitioners are instructed to accept them and allow the recognition of these stimuli to come and go without judging or getting involved. When attention has drifted off and is becoming caught up in thoughts or feelings it is advised that the practitioner notes this drift and gently brings attention back to breathing (Grecucci et al., 2015).  

Mindfulness is an intrinsic and modifiable capacity of the human mind (Black & Slavich, 2016).  Being mindfulness means paying attention to current experience instead of focusing on the past or the future. It’s living here and now, being intentionally present.  It is accepting the moment without judging it. Mindfulness meditation encourages individuals to focus on their internal experiences such as bodily sensations, thoughts, and emotions (Melloni et al., 2013). It is the   non-judgmental observation of the ongoing stream of internal experiences as they arise (Hölzel et al., 2008). It is being alert and awake about the every present moment (Patil, 2009). Mindfulness understanding is a decreased attachment to the self, higher self-compassion and lower emotional reactivity to inner experience.

Mindfulness is a capacity for heightened present-moment awareness. Mindfulness meditation is an inward mental practice in which a resting but alert state of mind is maintained (Ahani et al., 2013). Mindfulness corresponds to the higher-level awareness of present-moment sensory, affective, and cognitive experiences (Desbordes et al., 2015). Shauna Shapiro, Ph.D - Professor of Psychology at Santa Clara University and internationally recognized expert in mindfulness (Personal Communication , 2018) states that mindfulness is intentionally paying attention with kindness. She further states  transformation is possible through kind attention.

Mindfulness meditation is an effective cognitive technique for the development of self-awareness (Kutz et al., 1985) and has the capacity to adopt an “observing self (Birnbaum, 2005).  According to Shyam (1994) mindfulness meditation promotes self awareness. Training in mindfulness, the deliberate awareness of moment-to-moment experience with an attitude of acceptance and non-judgement, is thought to foster health benefits and adaptive coping skills with potential lifelong relevance (de Vibe et al., 2018).

The goal of mindfulness is to maintain awareness moment by moment, disengaging oneself from strong attachment to beliefs, thoughts, or emotions, thereby developing a greater sense of emotional balance and well-being (Ludwig & Kabat-Zinn, 2008). Mindfulness meditation typically focuses on several domains, including bodily sensations, states of mind, and interactions between one’s behavior and the universe (Harvey, 1990).

Mindfulness meditation is regarded as a mind-body therapy or integrative body–mind training. It has beneficial effects on brain and body (Krygier et al., 2013). This is an attention-based, regulatory and self-inquiry training regime (Lutz et al., 2008). Over the past 35 years, mindfulness meditation practices have increasingly been integrated into Western medical settings (Wilson et al., 2017). Kabat-Zinn and colleagues found that mindfulness based meditation program had sustained positive effects in reduction in pain, psychological and overall health measures (Patil, 2009).  Mindfulness meditation is a form of mental training that involves observation of the constantly changing patterns of internal and external experience moment to moment (Fulwiler et al., 2015).
Attachments and cravings lead to human suffering. According to Wijsbek (2012) suffering is not purely subjective in the sense of being entirely private. Suffering is not a symptom like pain or fear and suffering occurs when a person interprets his /her experience as a threat to his/ her integrity (Gupta et al., 2017). Mindfulness transforms suffering through changes in what the mind is processing, changes in how the mind is processing it, and changes in the view of what is being processed (Teasdale & Chaskalson, 2011).

Mindfulness is a shift in perspective associated with decreased attachment to one’s thoughts and emotions (Brown et al., 2015). Mindfulness meditation is a foundational practice for reducing psychological suffering (Kang & Whittingham, 2010). When mindful, people are sensitive to the context and the environment, they welcome novelties, they create new categories for structuring perception, and they present multiple perspectives in problem solving (Langer and Moldoveanu, 2000; Moafian et al., 2017).  

The scientific interest on mindfulness meditation has significantly increased in the last two decades probably because of the positive health effects (Crescentini & Capurso, 2015). Mindfulness may promote a more participatory medicine by engaging and strengthening an individual’s internal resources for optimizing health in both prevention of and recovery from illness (Ludwig & Kabat-Zinn, 2008).  Gestalt therapy and Morita’s therapy use the techniques based on the concept of mindfulness (Marciniak et al., 2014).  

Intricate neural mechanisms are associated with mindfulness meditation. Mindfulness augments brain activation and modifies neural processes. The neural processes in medial cortex, lateral frontal regions, basal ganglia and hippocampus have been observed during mindfulness meditation (Marchand, 2014).  Levine and team (2017) report that a 2‐month mindfulness meditation program resulted in increased left‐sided anterior brain electrical activation, a pattern associated with positive affect and emotion.

The beneficial clinical effects of mindfulness practices are receiving increasing support from empirical studies (Chiesa et al., 2013). Mindfulness-based approaches are increasingly employed as interventions for treating a variety of psychological, psychiatric and physical problems (Chiesa & Malinowski, 2011). Long-term practice of mindfulness leads to emotional stability by promoting acceptance of emotional states and enhanced present-moment awareness (Taylor et al., 2011). Mindfulness enhanced emotional regulation (Marchand, 2014).

Mindfulness has been shown to reduce stress, promote health, and well-being, as well as to increase compassionate behavior toward others (Laneri et al., 2017).  According to Naranjo and  Schmidt  (2012) mindfulness meditation practice is associated with slower body movements which in turn may lead to an increase in monitoring of body states and optimized re-adjustment of movement trajectory, and consequently to better motor performance.

The benefits of mindfulness are now beginning to be understood at a neurobiological level (Sarris et al., 2012). Ivanovski and Malhi (2007) state that mindfulness-based therapeutic interventions appear to be effective in the treatment of depression, anxiety, psychosis, borderline personality disorder and suicidal / self-harm behaviour. Mindfulness meditation might be of therapeutic use by inducing plasticity related network changes altering the neuronal basis of affective disorders such as depression (Yang et al., 2016). Mindfulness is associated with high levels of self-esteem and satisfaction with life (Brown & Ryan, 2003). Collins and team (2018) mindfulness protects against suicidal desire in conditions of heightened risk and adversity by enhancing one's orientation towards a life worth living.

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