- What is Mindfulness?
- Mindfulness as Process and Outcome
- Mechanisms of Action
- The Importance of Stress Reduction
Mindfulness refers to intentionally being present in the present moment with acceptance and non-judgement. The term is derived from a form of Buddhist meditation and equates to the Pali words sati and sampajana, referring to awareness, discernment, circumspection, and retention (Shapiro & Carlson, 2009).
Although the term is of Buddhist origins, mindfulness is ubiquitous – a natural part of being human. We have all experienced at least moments of mindfulness, of being fully present to the present moment. During such moments, we often experience the vividness of small details and the potential richness of our experience. We become aware of the world around us and within us: the light filtering through the curtains, the smell of the neighbours’ dinner, the percussive rat-a-tat-tat of a woodpecker, the pulse in our fingertips, our fleeting thoughts and emotions, our own breath.
Unfortunately, we pass through much of our lives mindlessly on automatic pilot – body present, awareness elsewhere – planning for the future, thinking about the past, trapped by conceptualisations or assumptions and by our unconscious physical, emotional, and cognitive patterns and conditionings. On automatic pilot we are partially absent to the events that make up our lives. We cannot experience pleasant events, sensations, connections with others, or even joy if we are not present to them. And we cannot "tune out" unpleasant thoughts, sensations, emotions, or experiences without also shutting out the potentially wonderful moments that may arise simultaneously.
Mindfulness refers to both a process and an outcome – mindful practice and mindful awareness, respectively (Shapiro & Carlson, 2009).
Process
Mindful Practice has been described as “the systematic practice of intentionally attending in an open, caring and discerning way” (Shapiro & Carlson, 2009). Mindfulness exercises include formal and informal exercises.
Formal exercises form the basis of the practice and are practiced daily in a time that has specifically been set aside for them. Like finger exercises as one learns to play a musical instrument, they are required to develop proficiency and to reap the benefits – which are potentially extensive; burgeoning research on the mind-body connection points to the state of mind as having significant influence on physiology/health of brain and body – right down to gene expression (epigenetics).
Formal exercises frequently begin by developing mindful awareness of the body through the Body Scan Exercise and mindful hatha yoga. Sitting Mindfulness Meditation is often introduced with a focus on awareness of breath. Focused Attention (FA) can then be extended to various sensory modalities, culminating in sitting without any particular focus (Open Monitoring-OM) – allowing whatever arises in awareness to rise and fall, just as it is, noticing when the mind has wandered out of the present moment, and gently redirecting awareness back into the present. Mindful Walking involves slowing down to bring full awareness to the process of walking: the intention to lift one leg, the shift of weight from one leg to the next, the lifting, placing, contact with the floor, etc. Loving Kindness Meditation focuses on generating and sustaining compassion (comparable to what psychologist Carl Rogers termed unconditional positive regard) for others and for ourselves – a process that has been known to take years in traditional western psychotherapies.
Informal Exercises are practiced throughout the day, heightening awareness as fully as possible in order to experience the present moment, one moment at a time. Awareness can be focused on physical sensations, sounds, visual stimuli, conversations, walking, the breath, or whatever is occurring in the present moment.
Outcome
Mindful Awareness is a way of being in which one has an open awareness of all that arises in one’s realm of experience, moment by moment. This can include accepting, non-judgemental awareness of:
a) Internal events (including physical sensations, thoughts, emotions, reactions);
b) External events (including sights, sounds, other people); and
c) The interplay between internal and external, or even between internal aspects of mind or other aspects of self.
1. Reduction of stress and of the researched, potentially detrimental effects of stress physiology on brain and body.
2. Development of increased awareness of physical sensations, thoughts, emotions, and all aspects of one’s internal and external environments. Such awareness offers opportunities to step out of autopilot and conditioned reactions to consciously choose more adaptive, healthy responses – for instance, disengaging from maladaptive thought and behavioural patterns, including those causing vulnerability to stress reactions and psychopathology.
3. Measurable changes to various areas of the brain, including:
a) Prefrontal Cortex (Lazar et al., 2005; Holzel et al., 2007): executive brain function such as attentional regulation, working memory, affective regulation, impulsivity.
b) Insula (Lazar et al., 2005; Holzel et al., 2007)
c) Limbic System (Newberg, & Iversen, 2003)
One significant, researched benefit of mindfulness is stress reduction.
Stress has been demonstrated to have negative effects on the body – including the brain – as well as on psychological health:
a) Telomeres shorten and telomerase levels decrease more rapidly, resulting in accelerated cell aging.1
b) Detrimental effects on prefrontal cortex functioning.
c) Immune function suppression.
d) Psychological distress. 2
e) Increased depression. 3
f) Decreased job satisfaction. 4
g) Disrupted personal relationships. 5
Stress also poses potential harm to professional effectiveness:
a) Decreased attention. 6
b) Reduced concentration. 7
c) Compromised working memory and affective regulation.
d) Compromised decision making. 8
e) For physicians, decreased ability to form effective relationships with patients. 9
f) For physicians, job burnout 10 and distress: a syndrome of depersonalization, emotional exhaustion, and a sense of low personal accomplishment. Associated suboptimal self-reported patient care 11 and decreased patient satisfaction. 12
Training in mindfulness, such as through Mindfulness-Based Stress Reduction, has been shown to measurably alter detrimental effects of stress, such as those listed above.