Mindfulness-Based Stress Reduction in Medicine
Mindfulness-Based Stress Reduction has
been consistently documented as highly effective in teaching participants
to become more responsible in the management of their own health,
vitality and healing. Two decades of published research (see "References"
below) indicates that the majority
of people who complete the MBSR Program report lasting decreases
in physical and psychological symptoms. The studies report:
- Dramatic reductions in pain levels and an enhanced ability to cope with pain that may not go away
- Dramatic decreases of anxiety, depression, hostility and the tendency to somatize
- More effective skills in managing stress
- An increased ability to relax
- Greater energy and enthusiasm for life
- Improved self-esteem
- An ability to cope more effectively with both short and long-term stressful situations
The research supporting these results is extensive and ongoing at numerous universities, medical schools and private sector research groups. In the interest of brevity, research on Chronic Pain, Anxiety and Depression conducted at the University of Massachusetts Medical Center (UMASS) will be highlighted in addition to the Brain and Immune Functioning Studies recently published and currently being investigated.
In the pain studies, people with chronic pain such as headaches, back pain, neck pain and fibromyalgia who participated in the Mindfulness-Based Stress Reduction Clinic reported a dramatic reduction in the average level of pain during the eight-week training period and for at least four years following the treatment.
An Outpatient Program in Behavioral Medicine for Chronic Pain Patients Based on the Practice of Mindfulness Meditation
- Kabat-Zinn, J.
- General Hospital Psychiatry
- 1982
Results
Pain:
- 1/2 of patients >> 50% decrease
- 2/3 of patients >> 33% decrease
- significant increase in life activities
Medical symptoms (MSCL):
- 1/2 of patients >> 33% decrease
- 1/3 of patients >> 50% decrease
Psychological symptoms (GSI):
- 1/2 of patients >> 33% decrease
- 1/3 of patients >> 50% decrease
Mood symptoms (TMD):
- 2/3 of patients >> 50% decrease
- 3/4 of patients >> 33% decrease
In another pain study, two groups of pain patients were compared. All 42 people in this study were being treated in the hospital’s pain clinic using standard medical protocols as well as supportive therapies such as physical therapy. But one group of 21 patients also participated in the MBSR program in addition to their pain clinic treatments, while the other group had not yet been referred to the stress clinic. Both groups were followed over a ten week period, the MBSR participants between the time they started and the time they finished the stress clinic; the other group between the time they started their pain clinic treatments and ten weeks later.
The Clinical Use of Mindfulness Meditation for the Self-Regulation of Chronic Pain
- Kabat-Zinn, J.
- Journal of Behavioral Medicine
- 1985
Results
Pain:
- 3/4 of patients >> 33% decrease in pain
- 1/2 of patients >> 50% decrease in pain
- 44% of patients >> decreased analgesic use
- 28% of patients >> discontinued analgesics
Mood:
- 1/2 of patients >> 33% decrease
- 1/3 of patients >> 50% decrease
Compliance:
- 70% still meditating at follow-up
Pain Clinic comparison group:
- no significant improvement
It was known from previous studies that they could expect MBSR participants to show large reductions in pain and psychological distress on our rating scales. The question was, "How would the MBSR participants compare with other patients in the pain clinic who were not practicing mindfulness but who were receiving powerful medical treatments for pain?" The result was that the patients who did not have MBSR showed little change over the ten weeks that they were being treated in the pain clinic, while the MBSR participants showed the expected major improvements.
A brief review of studies investigating the value of MBSR in the treatment of anxiety, depression, fibromyalgia and quality of life:
Effectiveness of a Meditation-Based Stress Reduction Program in the Treatment of Anxiety Disorders
- Kabat-Zinn, J.
- American Journal of Psychiatry
- 1992
Results:
- 20/22 individual improvement
- 25-65 % decrease in mean Hamilton and Beck depression and anxiety scales
- decreased frequency of panic attacks
- decreased medical symptoms (MSCL)
- gains maintained at 3 month follow-up
- 90% still using techniques at 3 months
Prevention of Relapse/Recurrence in Major Depression by Mindfulness-Based Cognitive Therapy (MBCT)
- Teasdale, et al
- Journal of Consulting and Clinical Psychology
- 2000
Results:
- 66 % of those who learned mindfulness remained stable
(no relapse) over 1 year, compared with 34% in a control group
A Pilot Study of Cognitive Behavioral Therapy in Fibromyalgia
- Singh, et al
- Alternative Therapies
- 1999
Results:
- decreased pain
- decreased anxiety
- decreased depression
- decreased fibromyalgia impact
- improved global assessment
Mindfulness-Based Stress Reduction and Health Related Quality of Life in a Heterogeneous Patient Population
- Diane Reibel, Ph.D , ET AL
- Jefferson-Myrna Brind Center of Integrative Medicine Thomas Jefferson University
- 2000
Results:
- Statistically significant changes were found on all 8 indices of the
SF-36 Health Survey
- Bodily Pain scores improved by approximately 25%
- Role Limitations due to Physical Health by 50%
- Vitality improved by 40%
- Significant improvements on all SCL-90 subscales were also noted
with moderate to large effect sizes
- Global Severity Index was reduced by 33%
- Anxiety, Depression and Somatization group scores dropped by 40%
- Improvements represent clinically or socially relevant changes
Finally, one study that employed physiologic markers to measure the influence of MBSR suggests that there may be multiple biological consequences of mindfulness training relevant to emotional and physical health. This research has spawned a great deal of additional research currently being conducted employing physiologic markers:
Affect, Health and Meditation:
Perspectives from Affective Alterations in Brain and Immune Function Produced by
Mindfulness Meditation
- Richard Davidson, Ph.D., Jon Kabat-Zinn, et al
- University of Wisconsin-Madison
- 2003
Results:
- In addition to anxiety reduction, meditator’s also showed significant
improvement in immune functioning
References
Mindfulness-Based Stress Reduction (MBSR)
Therapies and Interventions Incorporating Mindfulness
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: The Guilford Press.
Singh, N. N., Wahler, R. G., Adkins, A. D., & Meyers, R. E. (2003). Soles of the feet: A mindfulness-based self-control intervention for aggression by an individual with mild mental retardation and mental illness. Research in Developmental Disabilities, 24, 158-169.
Zettle, R. D. (2003). Acceptance and Commitment Therapy (ACT) vs. systematic desensitization in treatment of mathematics anxiety. The Psychological Record, 53, 197-215.
Borderline Personality Disorder, Chronic Distress (DBT)
Holmes, E. P., & Dykstra, T. (2003). A contextual behavioral approach to Dialectical Behavior Therapy. Manuscript submitted for publication.
Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: The Guilford Press.
Linehan, M. M. (1993). Skills training manual for treating borderline personality disorder. New York: The Guilford Press.
Mindfulness Movement
Gannon, L., & Sternbach, R. A. (1971). Alpha enhancement as a treatment for pain: A case study. Journal of Behaviour Therapy & Experimental Psychiatry, 2, 209-213.
Girodo, M. (1974). Yoga meditation and flooding in the treatment of anxiety neurosis. Journal of Behavioral Therapy & Experimental Psychiatry, 5, 157-160.
Jin, P. (1992). Efficacy of Tai Chi, brisk walking, meditation, and reading in reducing mental and emotional stress. Journal of Psychosomatic Research, 36(4), 361-370.
Mills, N., & Allen, J. (2000). Mindfulness movement as a coping strategy in multiple sclerosis: A pilot study. General Hospital Psychiatry, 22, 425-431.
Mindfulness Meditation and Mindfulness Training (general)
Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125-143.
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822-848.
Deatherage, O. G. (1996). Mindfulness meditation as psychotherapy. In Boorstein, S. (Ed.), Transpersonal psychotherapy (2nd ed., pp. 209-226). Albany: State University of New York Press.
Delmonte, M. M. (1984). Psychometric scores and meditation practice: A literature review. Personality & Individual Differences, 5(5), 559-563.
Dimidjian, S., & Linehan, M. (2003). Defining an agenda for future research on the clinical application of mindfulness practice. Clinical Psychology: Science and Practice, 10(2), 166-171.
Epstein, M. (2001). Going on being: Buddhism and the way of change. New York: Broadway Books.
Gorton, G. E. (1985). Can East and West Meet in Psychoanalysis? [Letter to the editor]. American Journal of Psychiatry, 142, p. 1227.
Hanh, T. N. (1990). Transformation & healing: Sutra on the four establishments of mindfulness. Berkely, California: Parallax Press.
Hayes, S. C. (2002). Acceptance, mindfulness, and science. Clinical Psychology: Science and Practice, 9(1), 101-106.
Hayes, S. C. (2001). Acceptance and change, Psychology of. In International Encyclopedia of the Social & Behavioral Sciences (pp. 27-30). Publisher information unavailable.
Hayes, S. C., & Wilson, K. G. (2003). Mindfulness: Method and process. Clinical Psychology: Science and Practice, 10(2), 161-165.
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144-156.
Kabat-Zinn, J. (1994). Wherever you go, there you are. New York: Hyperion Press.
Kokoszka, A. (1986). Limitations of a psychobiological concept of the integration of psychotherapy and meditation [Letter to the editor]. American Journal of Psychiatry, 143, p. 1315.
Kutz, I., Borysenko, J. Z., & Benson, H. (1985). Meditation and psychotherapy: A rationale for the integration of dynamic psychotherapy, the relaxation response, and mindfulness meditation. American Journal of Psychiatry, 142, 1-8.
Roemer, L., & Orsillo, S. M. (2003). Mindfulness: A promising intervention strategy in need of further study. Clinical Psychology: Science and Practice, 10(2), 172-178.
Sugiura, Y. (2003, in press). Detached mindfulness and worry: A meta-cognitive analysis. Personality and Individual Differences.
Teasdale, J. D., Segal, Z. V., & Williams, J. M. G. (Summer 2003). Mindfulness training and problem formulation. Clinical Psychology: Science and Practice, 10(2), 157-160.
West, M. A. (1980). The psychosomatics of meditation. Journal of Psychosomatic Research, 24, 265-273.
Philosophical Issues
Goleman, D. (1996). Meditation and consciousness: An Asian approach to mental health. In Boorstein, S. (Ed.), Transpersonal psychotherapy (2nd ed., pp. 227-240). Albany: State University of New York Press.
Taylor, E. (2003). A perfect correlation between mind and brain: William James's Varieties and the contemporary field of mind/body medicine. The Journal of Speculative Philosophy, 17(1), 40-52.
Langer’s Research and Related Articles
Burgoon, J. K., Berger, C. R., & Waldron, V. R. (2000). Mindfulness and interpersonal communication. Journal of Social Issues, 56(1), 105-127.
Demick, J. (2000). Toward a mindful psychological science: Theory and application. Journal of Social Issues, 56(1), 141-159.
Horton-Deutsch, S. L., & Horton, J. M. (2003). Mindfulness: Overcoming intractable conflict. Archives of Psychiatric Nursing, XVII(4), 186-193.
Langer, E. J. (1989). Mindfulness. Cambridge, Massachusetts: Perseus Books.
Langer, E. J. (2000). Mindful learning. Current Directions in Psychological Science, 9(6), 220-223.
Langer, E. J., & Moldoveanu, M. (2000). Mindfulness research and the future. Journal of Social Issues, 56(1), 129-139.
Langer, E. J., & Moldoveanu. (2000). The construct of mindfulness. Journal of Social Issues, 56(1), 1-9.
Napoli, M. (2004). Mindfulness training for teachers: A pilot program. Complementary Health Practice Review, 9(1), 31-42.
Reiss, S. (2000). A mindful approach to mental retardation. Journal of Social Issues, 56(1), 65-80.
Ritchhart, R., & Perkins, D. N. (2000). Life in the mindful classroom: Nurturing the disposition of mindfulness. Journal of Social Issues, 56(1), 27-47.
Sternberg, R. J. (2000). Images of mindfulness. Journal of Social Issues, 56(1), 11-26.
|