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Mindfulness-Based Stress Reduction

Mindfulness-Based Stress Reduction

Mindfulness-based stress reduction is a widely researched anti-stress programme worldwide, and is a growing part of mainstream medicine, writes Karen Koch

EXERCISING mindfulness is not just another instant magic bullet or self-help fad for remnants of the flower power, hippy generation. It is a technique that is a growing part of mainstream medicine - with over 200 training units affiliated with medical centres and hospitals around the world.

Even the US army is said to be illness-based stress reduction to arm marines mentally against psychological strain and reduce the likelihood of post-traumatic disorder from combat duties.

But what exactly is it?

Since its introduction, mindfulness-based stress reduction has become one of the most widely researched stress reduction programmes worldwide.

It was developed by psychologists at the University of Massachusetts, Medical Centre in 1979. It is described as essentially a way of "paying attention, in a particular way: on purpose, in the present moment, with acceptance'', according to one of its founders, Dr Jon Kabat-Zinn.

Kabat-Zinn is professor of medicine emeritus, and founding director of the Stress Reduction Clinic and Centre for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School.

He was a student of Zen Master Seung Sahn, and is a founding member of the Cambridge Zen Centre. He is author of a range of best-selling books on the topic. These include Wherever You Go, There You are: Mindfulness Meditation for Everyday Life (Piatkus), and Full Catastrophe Living: How to Cope with Stress, Pain and Illness Using Mindfulness Meditation (Piatkus).

In 2008, the newly formed Institute for-Mindfulness in SA in conjunction with the University of Cape Town Graduate School of Business hosted Kabat-Zinn on his first visit to this country.

He gave a public lecture entitled Coming to our senses: healing ourselves in ways little and big through mindfulness, and a two-day day retreat for business and "thought" leaders, entitled the power of mindfulness.

Linda Kantor, a counseling psychologist and co-director of the Cape Town-based mindfulness-based stress reduction course, calls the technique "present moment awareness".

But what is the benefit of mindfulness-based stress reduction?

University of Pennsylvania cognitive neuroscientist Dr Amishi Jha, of the department of psychology and Centre for Cognitive Neuroscience at Georgetown University says in a report that, "just as daily physical exercise leads lo physical fitness, engaging in mindfulness exercises on a regular basis may improve mind-fitness".

Jha's findings, published in the Journal of Emotion last year, showed that building mind-fitness with mindfulness training may help anyone who must maintain peak performance in the face of extremely stressful, circumstances, from first responders, relief workers and trauma surgeons, to professionals and Olympic athletes.

Mindfulness-based techniques have also been widely used in education at all levels, and specialists say evidence suggests it may help children of all ages cope with stressful life circumstances.

While the technique is being more, widely adopted by those seeking to improve performance, its original benefit was first studied in those with chronic conditions ranging from anxiety and depression to psoriasis and fibromyalgia.

The findings have been convincing enough for the official UK Nice (National Institute for Health and Clinical Excellence) guides (adopted by the country's National Health Service) to recommend mindfulness-based stress reduction formally as a treatment to prevent depression relapse. (Experts in the method say it is not most helpful for people in the middle of a very severe bout of depression.)

Dr Paul Grossman from the University of Freiburg, Germany, in a 2004 review of over 60 clinical trials published in the Journal of Psychosomatic Research, found that mindfulness-based stress reduction was a useful intervention for many chronic disorders.

His research showed that mindfulness-based stress reduction consistently improved standard mental health measures, such as quality of life, depression, anxiety and coping style as well as medical symptoms, sensory pain and physical impairment in both randomized control trials and observational studies.

The method has also been shown to have significant effects on chronic pain and fatigue conditions such as fibromyalgia.

Canadian scientist Dr Tara Sampalli, of Nova Scotia Environmental Centre in Canada, in the Journal of Multidisciplinary Healthcare in 2009, says that "mindfulness-based stress reduction gives patients a broader perspective.

"Turning attention to the breath brings acceptance to the present moment without judgment of pleasant, unpleasant, or neutral feelings. In this way resiliency to seeing things as they are, and gaining some distance and perspective on them begin to take hold," she says.

In the June 2009 issue of Psycho-Oncology, Dr Dianne Ledesma reviewed several studies and demonstrated that mindfulness-based stress reduction could effectively help patients with cancer adjust to their disease.

The Indiana University Simon Cancer Centre runs a course for cancer survivors and their families. Dr Kathleen Beck-Coon, who facilitates the programme, is quoted as saying it helps her cancer patients to regain a sense of wholeness.

Numerous other studies, including one in the Journal of Current Oncology 2010, show changes in depression, stress, emotional coping, and sense of coherence in cancer survivors practicing this stress reduction.

But exactly what is mindfulness-based stress reduction and what does the training arid practice of it involve?

The training takes the form of an eight-week programme. This consists of weekly evening sessions, as well as a full weekend.

Trainees are normally assessed before the programme begins to understand any mental or physical conditions they may have.

The course focuses on numerous techniques to create mindfulness, such as body scanning, walking and yoga practice.

Body scanning is a practice of devoting moment-to-moment attention to the body just as it is. Typically it is performed lying down, but can be practiced in any position.

It involves direct broad, expansive attention to the body as a whole, then systematically focused attention to different parts of the body. The aim is to become aware of sensations, and mental reactions to paying attention to parts of the body,

Participants are encouraged to follow a daily routine of 40 to 60 minutes of mindfulness practice.

How does mindfulness-based stress reduction work its magic?

"It teaches people that to be human entails some degree of suffering" says Kantor.

"By being in the moment and letting go of the idea of their 'illness', people experience relief from their symptoms. We try to (show) that there is more 'right' with them than "wrong". They are not simply their disease."

Mindfulness-based stress reduction is also thought to have an effect on the autonomic nervous system.

Researchers say the method can take people out of their hyper vigilant state, altering their state of psychological arousal.

Essentially this shift from the sympathetic nervous system (fight or flight response) to the parasympathetic nervous system (all is well response) helps to reduce subjective feelings of panic and stress.

In a report in Psychiatry Research Neuroimaging in 2010, Dr Britta Holzel from Harvard University found that an eight-week programme resulted in increases in grey matter density in areas of the brain associated with learning and memory processes, emotion, control, self-referential processing and perspective taking.

These increases were found in the left hippocampus, posterior cingulated cortex (PCC), the temporo-paretal junction (TPJ) and the cerebellum.

While it makes sense that treatments focused on the mind must have an effect on the body, mindfulness-based stress reduction provides one of the first well-researched and structured techniques to give insight into these effects.

Dr Karen Koch is a Johannesburg GP and health writer


It is not easy to always be present, it is not easy to always remember to fit mindfulness in my life, but each time I do, I am rewarded in abundance, even in the difficult times.
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