Mindfulness and its Connection
to Mental Health
by Andrew Safer
June 2010
Many people struggle with persistent negative thinking, tunnel vision, compulsive thoughts, and mistaking fantasy for reality. They become victims of their own thought processes and are powerless to get away from them. These thoughts become controlling, boxing them in to limited possibilities.
“Mindfulness” is an approach to working with one’s mind that enables the individual to relate objectively and non-judgmentally to thoughts, sensations, feelings, and emotions. Based on the ancient Buddhist meditation practice of “shamatha” (“calm abiding”), Mindfulness is currently being applied in a variety of non-religious and non-sectarian contexts to assist individuals who are dealing with chronic pain and a variety of distressing mental health issues.
Mindfulness practice trains the individual to allow thoughts, emotions, and sensations to simply occur, and to recognize them for what they are without becoming involved in their content. Rather than becoming mesmerized by never-ending storylines set in the past or future, by practicing Mindfulness, one is better able to remain in the present. It is a different way of relating with the mental chatter, judgments, self-criticism, self-doubt, and fixed views that can otherwise dominate one’s thinking and one’s life.
Contents
Beginning in 1979, Jon Kabat-Zinn pioneered the application of Mindfulness for individuals suffering with chronic pain, and later for individuals struggling with depression and anxiety. Kabat-Zinn is Professor of Medicine Emeritus and founding director of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School.
Research to date indicates that the practice of Mindfulness is proving to be effective in:
- reducing impulsivity
- reducing negative affect
- improving emotional regulation
- improving the ability to sustain attention/focus
- improving the ability to process information when under stress
- increasing awareness and control of mental states and processes
- assisting in the process of dealing with anger
- significantly reducing relapse rates for people with three or more previous depressive episodes
- aiding in the treatment of generalized anxiety disorder and panic
- positively affecting brain and immune function
According to "Experiment Shows Brief Meditative Exercise Helps Cognition", a study undertaken by Fadel Zeidan, a post-doctoral researcher at Wake Forest University School of Medicine, Susan K. Johnson, Zhanna David and Paula Goolkasian from the Department of Psychology at the University of North Carolina Charlotte, and Bruce J. Diamond from William Patterson University:
- Meditation-trained participants showed a significant improvement in their critical cognitive skills (and performed significantly higher in cognitive tests than a control group) after only four days of training for 20 minutes per day.
- The meditation group scored as much as ten times better on a test that involved the ability to focus, while holding other information in mind.
- In tasks where participants had to process information under time constraints causing stress, the group briefly trained in mindfulness performed significantly better.
- Mindfulness meditation teaches you to release sensory events that would easily distract, whether it is your own thoughts or an external noise, in an emotion-regulating fashion.
"Prevention of Relapse/Recurrence in Major Depression by Mindfulness-Based Cognitive Therapy"
by John D. Teasdale, Medical Research Council, Cognition and Brain Sciences Unit, Zindel V. Segal, Centre for Addiction and Mental Health, Clarke Division, and University of Toronto, Mark G. Williams, University of Wales, et al, was published in the Journal of Consulting and Clinical Psychology in 2000.
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Risk of relapse and recurrence will be reduced if patients who have recovered from episodes of major depression can learn, first, to be more aware of negative thoughts and feelings at times of potential relapse/recurrence and, second, to respond to those thoughts and feelings in ways that allow them to disengage from ruminative depressive processing. Mindfulness-Based Cognitive Therapy (MBCT) was designed to achieve those aims.
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There is preliminary evidence for the effectiveness of Mindfulness-Based Stress Reduction in the treatment of generalized anxiety disorder (GAD) and panic (Kabat-Zinn et al., 1992) and chronic pain (Kabat-Zinn, Lipworth, Burney & Sellers, 1986).
- For patients with 3 or more previous episodes of depression (77% of the sample), MBCT significantly reduced risk of relapse/recurrence. MBCT approximately halved rates of relapse and recurrence over the follow-up period compared with patients who continued with treatment as usual.
- MBCT offers a promising cost-efficient psychological approach to preventing relapse/occurrence in recovered recurrently depressed patients.
- The present findings suggest that mindfulness-based clinical interventions may hold considerable therapeutic promise, either alone or in combination with other forms of intervention.
"Mindfulness in Forensic Mental Health: Does It Have a Role?"
was published in February 2010 by Kevin Howells of the Institute of Mental Health, Nottingham University, Allison Tennant and Robert Elmer of Peaks Unit, Rampton Hospital, Retford, UK, and Andrew Day of the Centre for Offender Reintegration, Deakin University, Melbourne, Australia. This paper considers the applicability of Mindfulness in the context of violent and sexual offending.
- Evidence is cited (Davidson et al) that Mindfulness alters both brain processes and immune function in a positive direction.
- The evidence indicates that Mindfulness is particularly relevant to the reduction of negative affective states, which have been identified as relevant to many forms of offending.
- Self-regulatory breakdown (particularly for negative affect) leading to impulsivity is widely recognized as an important causal influence for many forms of offending...By its nature, Mindfulness is about reducing impulsive responding by increasing awareness of mental states and their role in eliciting automatic and impulsive behaviour. Mindfulness promotes control of mental states and processes.
- For improving anger problems in offenders there would appear to be room for increasing the range and sophistication for anger interventions along Mindfulness lines.
- This paper cites the widespread existence and apparent popularity of meditation and similar groups within the prison system
- In conclusion, there would appear to be a prima facie case that Mindfulness has a role to play in risk management interventions for offenders and forensic patients.
“Research: Documented Benefits of Mindfulness” (Association for Mindfulness in Education)
“A New Mental Treatment Based On Attention Improves Anxiety And Depression In Secondary Education Teachers”
“Alterations in Brain and Immune Function Produced by Mindfulness Meditation”
“Mindful Relating: Exploring Mindfulness and Emotion Repertoires in Intimate Relationships”
“Are Deficits in Mindfulness Core Features of Borderline Personality Disorder?”
“The Dalai Lama on Urban Mindfulness, Violent Offenders, and Mad Dogs”
“The Benefits of Being Present: Mindfulness and Its Role in Psychological Well-Being”
Aftanas, L. and S. Golosheykin (2005). "Impact of regular meditation practice on EEG activity at rest and during evoked negative emotions." Int J Neurosci 115(6): 893-909.
Arch, J. J. & Craske, M. G. (2010). "Laboratory stressors in clinically anxious and non-anxious individuals: The moderating role of mindfulness." Behaviour Research and Therapy, 48(6), 495-505.
Brewer, J. A., Bowen, S., Smith, J. T., Marlatt, G. A., & Potenza, M. N. (2010). "Mindfulness-Based treatments for co-occurring depression and substance use disorders: What can we learn from the brain?" Addiction.
Britton, W. B., Bootzin, R. R., Cousins, J. C., Hasler, B. P., Peck, T., & Shapiro, S. L. (2010). "The contribution of mindfulness practice to a multicomponent behavioral sleep intervention following substance abuse treatment in adolescents: A treatment-development study." Substance Abuse, 31(2), 86-97.
Kristeller, J.L. & Halleh, C. B., "An exploratory study of a meditation-based intervention for binge eating disorder" , Journal of Health Psychology , 4: 357 - 363, 1999.
Piet, J., Hougaard, E., Hecksher, M. S., & Rosenberg, N. K. (2010). "A randomized pilot study of mindfulness-based cognitive therapy and group cognitive-behavioral therapy for young adults with social phobia." Scandinavian Journal of Psychology.
Zgierska, A. & Marcus, M. T. (2010). "Mindfulness-Based therapies for substance use disorders: Part 2. Substance Abuse", 31(2), 77-78.
“Roughly 100 years ago, William James wrote about ‘sustained voluntary attention’. He points out that some people seem to be naturally scatterbrained, whereas other people tend to be more collected, more able to pay attention…he said that an education system that could help train students to develop their ability for sustained voluntary attention would be the education system par excellence.”
(Goleman, Daniel. Destructive Emotions: How Can We Overcome Them? A Scientific Dialogue with the Dalai Lama. New York: Bantam Dell, 2003. p. 233)
***
“The mental activity most critical to the development of emotional self-regulation has been called ‘dispassionate self-observation’ by the authors of an important article on the interface of brain and mind, published in the Philosophical Transactions of the Royal Society (Biological Sciences) in 2005.
Mindful awareness involves directing our attention not only to the mental content of our thoughts, but also to the emotions and mind-states that inform those thoughts. It is being aware of the processes of our mind even as we work through its materials.”
(Maté, Gabor, In the Realm of Hungry Ghosts: Close Encounters with Addiction. Toronto: Vintage Canada, 2008. p. 344)
“The train of angry thoughts that stokes anger is also potentially the key to one of the most powerful ways to defuse anger: undermining the convictions that are fueling the anger in the first place. The longer we ruminate about what has made us angry, the more ‘good reasons’ and self-justifications for being angry we can invent. Brooding fuels anger’s flames. But seeing things differently douses those flames. Diane Tice found that reframing a situation more positively was one of the more potent ways to put anger to rest.
(Goleman, Daniel. Emotional Intelligence: Why It Can Matter More than IQ. New York: Bantam Books, 1995. p. 60)
***
“Zillmann* has found that when the body is already in a state of edginess...and something triggers an emotional hijacking, the subsequent emotion, whether anger or anxiety, is of especially great intensity. This dynamic is at work when someone becomes enraged. Zillmann sees escalating anger as ‘a sequence of provocations, each triggering an excitatory reaction that dissipates slowly.’ In this sequence every successive anger-provoking thought or perception becomes a minitrigger for amygdala-driven surges of catecholamines, each building on the hormonal momentum of those that went before…quickly escalating the body’s level of physiological arousal. A thought that comes later in this buildup triggers a far greater intensity of anger than one that comes at the beginning. Anger builds on anger; the emotional brain heats up. By then rage, unhampered by reason, easily erupts into violence.” (Ibid, p. 61)
*University of Alabama Psychologist Dolf Zillman
“Matthieu (Ricard*) then turned to a related theme, the timing of an intervention with a destructive emotion. Does one deal with such emotions after they arise, at the time they arise, or before they arise?
The first intervention—after they arise—is the beginner’s approach, because usually one realizes the negative or destructive aspects of some emotions only after having experienced them. You then use reason to investigate their consequences—seeing, for example, that a strong burst of hatred, which makes one perceive someone as entirely evil, can cause much suffering to others and certainly does not make us happy either. In this way, we can distinguish the emotions that bring happiness from those that cause suffering. It will then become clear that the next time such emotions are ready to arise, it is best not to give them free rein.
When one has gained some experience in this practice, the next stage is to deal with emotions as they arise. The crucial point here is to free emotions at the moment they surge into one’s mind, so that they don’t trigger a chain of thoughts that proliferate and take over the mind, thus compelling one to act—to harm somebody, for instance.”
(Goleman, Daniel. Destructive Emotions: How Can We Overcome Them? A Scientific Dialogue with the Dalai Lama. New York: Bantam Dell, 2003. p. 83)
*Matthieu Ricard is a Buddhist monk, photographer and author. He was working towards a Ph.D. degree in molecular genetics at the Institut Pasteur. in Paris. After completing his doctoral thesis in 1972, Ricard decided to forsake his scientific career and concentrate on the practice of Tibetan Buddhism.
***
“Appraisal awareness: witnessing our assumption, and influencing it by talking and questioning it.
Impulse awareness: After the appraisal, an impulse to action: choose whether to act on impulse.
Action awareness: Able to observe ourselves as we are acting, modify actions and interrupt or modify emotional habits as they are occurring.” (Paul Ekman) (Ibid, p. 145)
***
“Mindfulness meditation…offers a means of obtaining action awareness and impulse awareness (though he wonders if it can achieve appraisal awareness).” (Ibid, p. 145)
***
“Then the Venerable Kusalacitto went on to detail another aspect of mindfulness, concentration, in which the focus stays on a neutral object of awareness, typically the natural flow of the breath, and so wards off destructive emotions by blocking them.
'We can say that you have selected an alternative object in the mind. Instead of anger, envy, or aggression, now your mind has focused on a neutral object of awareness.'” (Ibid, p. 170)
***
“Brain research is demonstrating that mindful awareness is able to release the grip of harmful thoughts and also to change positively the physiology of the brain circuits where those thoughts originate.” (Ibid, p. 345)
October 8, 2002
Following is an interview with Dr. James Garbarino conducted by Mind Body Awareness Project Board Member Andrew Getz and by Soren Gordhamer, from the Mind Body Awareness Project web site: (reprinted by permission)
Mindfulness and Violent Youth
Dr. James Garbarino is a professor of Human Development at Cornell University and the the author of numerous books, including Lost Boys: Why Our Sons Turn Violent and How We Can Save Them, a pioneering book on the causes and solutions to youth violence. A national authority on youth aggression and violence, he has served as an expert witness in a number of youth homicide trials throughout the country. Dr. Garbarino is Co-Director of the Family Life Development Center in Ithaca, New York.
Andrew and Soren: How did you get interested in offering contemplative practices to very violent youth?
James Garbarino: One influence has been my partner, Claire Bedard. She has a very strong interest in spiritual development. A second influence is my own interest, going back to my college days and being interested in contemplative practices. Some of it also has been my own scrambling around working with these violent boys and wondering what might help transform them. I’ve also been very influenced by my friend and colleague, James Gilligan, who speaks a great deal on violence. He says something to the effect, “Only the person who is not fully alive, who is dead inside, can commit acts of violence. For anyone who loves life and is spiritually fulfilled, such acts are incomprehensible to them.”
AS: Taking that question a step further, based on the causes and conditions that you see bringing about violent behavior, how do you think meditation or yoga can help violent kids?
JG: I think there are several grounds for thinking that. One, the commonalties of untreated and unresolved traumatic experiences in their background argues for this. Anything that can help them deal with problems of arousal and focus and a way to manage emotions other than dissociation is a useful tool. A second reason is that the dominant larger culture is so unhelpful, if not outright hostile, to the development of spirituality and mindfulness because of its materialism and its nastiness that this is not something they are likely to get in the mainstream culture, let alone the fact that most of the kids come from the most socially-toxic environments. Nor is the secular educational system likely to provide this. So it is not likely accessible or presented to them otherwise. A third reason is the dynamic connection between spiritual emptiness and violent behavior. This would argue for trying to fill that spiritual emptiness through spiritually-grounded practices, as a way of disarming violence directly.
AS: Some people cannot believe that we go into to juvenile halls and youth prisons and teach contemplative practices. They say, “You go where and teach what to whom?” You’re going to teach a kid who is charged with murder how to meditate! What are you thinking?” How do you respond to such a question?
JG: Well, I would say from my observation and experience from visiting guys on death row, serving as an expert witnesses in many cases, I have observed that these people fall into two categories: monks and savages. The people who do not take the monk route, become savages. That’s how they seem to sort themselves out. The question, then, is how can we decrease the number of savages and increase the number of monks? This is to everyone’s advantage.
A second reason is that conventional approaches are so dismally unsuccessful that anybody should be open to trying something different, especially when you have recidivism in certain areas at 90%. Third, these are boys who have great difficulty managing intense emotions. They usually either dissociate or act out, and techniques of mindfulness are specifically designed to create the space with which these boys can control themselves better, which everyone says they want them to do. People have been working out the kinks in mindfulness practice for two thousands years. It has a track record we ought to go with. Also, I have seen first-hand kids make use of meditation. Most people do not have direct contact with kids in these institutions and they are at the mercy of second-hand accounts. And even the ones who do work there, when I tell them that kids in these places can thrive on meditation, they do not always believe me. The biggest impediment is not the youth, it’s the staff. We are doing a project on two units at a juvenile hall. In the unit where the staff is supportive of it, something like 90% of the kids are into it. In the class where the staff is not supportive, something like 20% to 30% are into it. Same population, same facility, same situation, different staff interest.
AS: What do you think are the cultural responsibilities for youth violence? When a violent youth or adult is let out of prison and commits a crime it is in all the newspapers. It is often the negative acts that get highlighted. As you know, it cost $40 billion dollars last year to house about 2 million adult prisoners. What do you think as a culture we can do to help turn this around? What can the average person do?
JG: I think one action is for people to talk to their legislatures about how we can use this money more wisely, which means putting more money into programs both inside the facilities and post-release. People can also look at what opportunities they have to support kids once they leave facilities. African-American churches used to have an adopt-a-child program. People might be able to get their church to adopt a child who is being released from a juvenile facility and help that person integrate back into the society.
AS: In the people who have taken the route of the monk versus the savage, what has brought that about? Have you seen any patterns?
JG: I don’t think I have an extensive enough database of knowledge to talk about the process. From my informal observation, one of the mechanisms is a newfound interest in education and developing a literary interest. Another is making the time, often out of desperation, to do the meditation so that it becomes so self-reinforcing that they feel a deprivation when they do not do it. Sometimes there is a specific influence like another inmate or volunteer who is helping them do this.
AS: We want to ask you a little more about the role of early trauma and how that influences violent youth. In your book you said that first kids need spiritual anchors, and that once that is in place, they can take on other forms of help like therapy to deal with trauma issues. Could you speak to this?
JG: Certainly, the damage of trauma provokes diminished future-orientation and produces terminal thinking, and all of these are fundamentally a crisis of meaninglessness which, in a sense, is a spiritual crisis. I think you can make a very good case that the most efficient way to address these symptoms is to first build, or in some instances create, a sense of spiritual grounding, spiritual connecting, so that self-improvement and therapeutic intervention makes sense. It becomes a much more efficient use of everyone’s time. It is really amazing the time spent trying to therapeutically intervene when it is often completely ineffectual. I think there is a good case to be made for improving the efficacy and efficiency and cost-effectiveness of these other interventions by first creating a more fertile climate for them, which is exactly what mindfulness meditation practice aims to do. Rather than saying that it is therapy or it is therapeutic, I think it is better to see it as building the context and the foundation in which therapy and other forms of interventions can thrive.
Since September 2009, Andrew Safer has given meditation instruction to several individuals dealing with a variety of mental health issues, and has been coaching them in the application of Mindfulness.
by B.
B. was a public notification sex offender 10 years ago when he was released into the community after serving five years in a federal prison. He was diagnosed with bipolar disorder early this year, and has impulse control issues. B. was referred by Turnings, the community-based organization that provides support services to help offenders reintegrate into the community.
Initial Report:
Had no confrontations. No bad thoughts, just regular thinking.
The breathing exercises are really helping me. I’m going to keep doing them.
More Detailed Report:
I’ve been doing this about three months. So far there have been two times when I normally would have reacted to situations that would have gotten me into trouble and maybe back in the lock-up. Instead of reacting I did the breathing and nothing happened. I have a feeling of control that I didn’t have before.
The first time I was standing at the bus stop. This guy I know from my past walked by and said, “Someone should run you over.” Normally, I would have gotten angry and said something to him that I shouldn’t have, and that would have started a fight. I would have ended up in the lock-up. (If he went to the RNC, they would believe him over me. Even though he has a criminal record and so do I, they would still believe him.) But instead, when he said it, I didn’t even open my mouth. I thought about the breathing and breathed in and out. He just kept on walking.
The second time, another guy I know from my past was saying bad stuff to my landlord and his son about me. He said that I said something that I didn’t say—he was spreading rumours about me. Then I saw him. If I was still the same way, I would have said something which would have ended up in a conflict. Instead, I did like before and breathed in and breathed out. I didn’t say nothing to him and he didn’t say nothing to me and he just left.
by P.
The practice of “sitting” has been beneficial to me. I suffer from relentless obsessive-compulsive disorder and extreme anxiety. Thus, my mind is often in a state of acute agitation. It is especially hard to meditate when my mind is extremely active.
I have found, though, that by maintaining awareness of my breathing, I do gain some equilibrium. Sometimes, it helps to label the overactive thinking as “thoughts”—although sometimes this is a daunting task.
I am a victim of my thinking and my emotions. I live with that; I meditate with that. Hopefully, I will gain greater awareness of my breath and a greater sense of well being, solid and confident. All I can do is practice.
***
by D.
I am in my late 30's and I have spent most of my life suffering from major depression, social anxiety, obsessive compulsive disorder (OCD), and attention deficit disorder (ADD). A friend introduced me to meditating in September of 2009 and I took it up, hoping it could help relieve my anxiety symptoms. I didn't notice much of a difference at first, but over time I started noticing a significant change. I have been meditating on almost a daily basis for almost 9 months now, and my anxiety is gradually getting better.
What I have found surprising, however, is that it not only seems to be easing my anxiety, but the symptoms of all of my afflictions as well. I have had hardly any depressive episodes since last fall, my compulsive behaviours have eased off significantly, and, a couple of months ago, I actually worked up the nerve to assist with a presentation. I stood up in front of a crowd of about 40 people and briefly related how meditation has helped me.
I am continuing my practice, and I am now hopeful that one day I may finally be healthy and able to enjoy life the way I want to.
Andrew Safer has been a practitioner of mindfulness meditation for over 40 years. He has been an instructor for 18 years.
Andrew began mindfulness meditation in the Zen Buddhist tradition in the late 1960’s shortly after he met Shunryu Suzuki, Roshi at Tassajara Zen Mountain Center in California. In 1973, he received instruction from the renowned meditation master, Chögyam Trungpa, continued to study with him until his death in 1987, and has maintained a regular mindfulness meditation practice since. Chögyam Trungpa was the founder of Vajradhatu—now called Shambhala International—a global community of more than 170 meditation centres.
At this time, Andrew is the senior meditation instructor at the St. John’s Shambhala Meditation Group.
He has presented on Mindfulness to the Independent Living Resource Centre, New Hope Community Centre, Community Youth Network, and Welcoming Spiritual Communities, a Mental Health Community Partnerships Project.
In his “other life” Andrew is a writer, youth program consultant, workshop facilitator, and trainer. He
- co-developed and wrote Healthy Relationships: A Violence-Prevention Curriculum
- developed and directed the Youth in Care Newsletter Project for Children’s Aid Society of Halifax from 2000 to 2008.
- taught a Violence Prevention course at the College of the North Atlantic
- facilitated workshops for Murphy Centre Career Services, Association for New Canadians, and several other community groups
- facilitated the training of youth outreach workers for Eastern Health.
Andrew facilitates workshops and training on:
- Youth Engagement
- Dealing With Difficult Emotions
- Communicating Assertively
- Bullying Prevention through Assertiveness
- Healthy and Unhealthy Relationships
- Mindfulness
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