Developing the evidence base for mindfulness therapies

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Rick Nauert PhD, PsychCentral: Therapeutic mindfulness interventions have grown in popularity over the past two decades. But some of the field’s leading researchers are concerned that the evidence base for such practices is not yet robust enough.

A new study from Brown University shows how a rigorous approach to studying mindfulness-based interventions can help ensure that claims are backed by science.

Researchers say that an analysis of mindfulness-based interventions (MBIs) is complicated as the therapies sometimes blend practices, which makes it difficult to measure how each of those components affects participants.

To address that issue, the …

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Power of positive thinking skews mindfulness studies

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Anna Nowogrodzki, Scientific American: There’s a little too much wishful thinking about mindfulness, and it is skewing how researchers report their studies of the technique.

Researchers at McGill University in Montreal, Canada, analyzed 124 published trials of mindfulness as a mental-health treatment, and found that scientists reported positive findings 60% more often than is statistically likely. The team also examined another 21 trials that were registered with databases such as ClinicalTrials.gov; of these, 62% were unpublished 30 months after they finished. The findings—reported in PLoS ONE on April 8— hint that negative results are going unpublished.

Mindfulness is the practice of being aware of thoughts and feelings without judging them good or bad. Mental-health treatments that focus on this method include mindfulness-based stress reduction—an 8-week group-based programme that includes yoga and daily meditation—and mindfulness-based cognitive therapy.

A bias toward publishing studies that find the technique to be effective withholds important information from mental-health clinicians and patients, says Christopher Ferguson, a psychologist at Stetson University in Florida, who was not involved in the study. “I think this is a very important finding,” he adds. “We’ll invest a lot of social and financial capital in these issues, and a lot of that can be misplaced unless we have good data.”…

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How mindfulness can help women with postpartum depression

Carolyn Gregoire, Huffington Post: More than 3 million American women suffer from postpartum depression each year — including up to 40 percent of women who have been treated for depression.

After working with many new and expecting mothers, Dr. Sona Dimidjian, a professor of psychology and neuroscience at the University of Colorado Boulder, began to question what her profession was doing to support these women — and decided to investigate an alternative solution to the conventional treatment. Those options, of psychotherapy and pharmaceuticals, aren’t always effective, and many women don’t want to take antidepressants …

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Mindfulness as effective as pills for treating recurrent depression

Sarah Boseley, The Guardian: Mindfulness-based cognitive therapy may be as good as pills at stopping people relapsing after recovering from major bouts of depression, according to a study.

Mindfulness-based cognitive therapy (MBCT) was developed from mindfulness techniques, which encourage individuals to pay more attention to the present moment, combined with cognitive behaviour therapy (CBT), specifically to try to help people who have recurring depression.

It teaches people to recognise that negative thoughts and feelings will return, but that they can disengage from them. Rather …

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The mindfulness boom and its modern misconceptions

wildmind meditation newsWorldcrunch: In 1979, a stressed-out molecular biologist took a Buddhist meditation technique, removed its mysticism, and transplanted it to an American university hospital. This is how mindfulness was born, in the University of Massachusetts Boston, instigated by Dr. Jon Kabat-Zinn.

The discipline then made its way into the medical world, where — according to scientific studies — it proved to be particularly effective to prevent depression relapses and to handle anxiety disorders. Incubation, blooming, booming. Now, 35 years after its birth, mindfulness is on everyone’s lips.

This is a crucial year for mindfulness, which represents the rare case of an originally Oriental practice infiltrating the West through science rather than spirituality. In February 2014, Time dedicated its front page to the topic with the headline “The Mindful Revolution,” marking its central place in the spirit of the times.

Soon after, concerned voices chimed in on both sides of the Atlantic Ocean asking if we shouldn’t also be afraid of it. Instead of the heavenly appeasement that one could gullibly expect of such a technique, a few practitioners revealed that mindfulness had plunged them into the torment of a mental void. Others, in larger numbers, often noted there was a difficult time to endure at one point or another. In the end, all this is probably a good thing. After the booming fad period, the perception of mindfulness is entering a phase where it is taken seriously.

“Patients have told me, ‘I’ve been through unpleasant side effects, but I didn’t dare say anything negative, because everyone is talking about mindfulness in such a positive way,'” says the British psychiatrist Florian Ruths, a practitioner and specialized researcher in mindfulness-based cognitive therapy at the United Kingdom’s National Health Service.

For him, this is a known problem. “Several studies show mindfulness can have unpleasant side effects,” he says. “Most of these are perfectly harmless, but when you experience them, you don’t necessarily know it.” The strongest and rarest of these, he says, are episodes of depersonalization, a sensation where, instead of being in your own life, you feel as if you were in a film, or as if the surrounding world wasn’t real. “Normally, it disappears in a few minutes,” he says. “Very rarely, it can last up to a few days. Our research will concentrate on this.”

Not a relaxation technique

Ruths makes the logical observation that everything that has an effect can also have side effects. “Mindfulness is a powerful intervention technique for patients suffering from depression, anxiety or stress,” he says. “This means it necessarily has an effect on the brain and particularly on its capacity to connect to your experience in a different way.”

Mindfulness is the idea that by improving the quality of your attention, you can manage to sense situations that cause stress. “Instead of reacting in an automatic way, which often increases discomfort, you then manage to put some space between you and the situation,” explains Guido Bondolfi, a psychiatry professor on the medical faculty at the University of Geneva.

As part of a joint project between the faculty and the Higher Health School of Geneva, Bondolfi just launched a Certificate of Advanced Studies (CAS) centered on mindfulness. Historically, mindfulness was developed for those left behind by allopathic medicine: people suffering from chronic diseases, obstructive pains resistant to conventional approaches or terminal illnesses for which there is not much to do beyond palliative care. The medical success of the approach has been certified by many studies — including Guido Bondolfi and his team’s, carried out with the support of the Swiss National Science Foundation.

“If you suffer from depression, a large part of what you are experiencing is negative thoughts about yourself, the world and other people,” Ruths says. “Instead of avoiding these thoughts, looking to distract yourself from them or weighing yourself down, we ask patients to sit down and feel what they are living, by letting thoughts flow without interfering. People often experience changes.”

It is therefore easy to understand that mindfulness may include unpleasant phases. Essentially therapeutic, the process is radically different from the search for a hypothetical ticket to nirvana. “Mindfulness meditation does not aim to get you high, to smoke a joint, to have your head in the clouds, look for altered states of consciousness,” Bondolfi insists. “It’s quite the opposite: be even more conscious than usual.”

There is of course a paradox because it’s not a relaxation session. In mindfulness, there is no specific goal or a dream place to go to. It’s about warmly welcoming our internal states. “The only intention you have is to open up and connect with your current state,” Bondolfi says, “which sometimes means being in a bad mood, feeling pain or wanting to shut the whole world out.”

The popularity of mindfulness, especially in the U.S., has had some setbacks, mostly with instructors whose backgrounds were not properly checked by unscrupulous private agencies. And Bondolfi says that “commonsense” is also necessary to prevent people suffering from severe mental disorders from practicing mindfulness. For the few who have been on the verge of the great void, they can be reassured by the fact that the ancient Buddhist texts predicted it. It is called “falling in the well of nothingness.”

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My broken leg healed in half the time…all because I meditated

Danny Penman: Meditation is often touted as a panacea for all manner of ailments, from chronic pain to anxiety, stress and even depression.

Like most sensible people, I’d always taken such sweeping claims with a large pinch of salt. However, five years ago I learned the power of meditation for myself after an accident left me critically injured and in constant pain.

A freak gust of wind caught me off-guard as I was paragliding over the Cotswolds. One moment my paraglider was flying normally, the next its wing had collapsed, sending me tumbling into the hillside 30ft below.
I was struck with the most agonising pain imaginable. The bone in the lower half of my right leg had been driven up through my knee and into my thigh.

I could see the outline of my fractured shin bone sticking through the cloth of my jeans. I went into shock and my body was racked with violent uncontrollable spasms.

As I lay on the hillside, I remembered a form of meditation Read the rest of this article…

I’d been taught in the sixth form of my comprehensive school in Neston, Cheshire, as a way of tackling exam nerves.

Over the years I’d used it to deal with the usual stresses and strains of daily life, but never in times of physical pain. But I knew that meditation (and self-hypnosis) had been used for pain relief and, as I lay on the hillside, in sheer desperation I tried them both.

I forced myself to breathe slowly and deeply, to focus on the sensations the breath made as it flowed in and out. I pictured myself in a beautiful garden and imagined myself inhaling its peaceful and tranquil air.
Gradually, breath by breath, the pain became more distant. It felt less ‘personal’, almost as if I was watching it on TV.

In hospital it became apparent how seriously injured I was — and just how effective a painkiller the meditation had been.
My leg was so badly broken that I would need three major operations. I also needed a newly invented device, a Taylor Spatial Frame, to be surgically attached to my leg for up to 18 months to repair the damage. Consisting of four equally spaced rings that encircled my lower leg, the frame looked like a cross between a Meccano set and a medieval torture device.

Fourteen metal spokes and two bolts connected these rings to the shards of bone inside my leg, and allowed the surgeon to move the fragments around inside.

Life with the frame was intolerable. Sleep was virtually impossible, and the pain was controlled with powerful drugs that left me washed-out and jaded.

I felt thoroughly wretched — anxious, irritable and highly stressed. So I decided to find an alternative way of coping with the pain and of maximising my chances of recovery.

I discovered the work of Mark Williams, professor of clinical psychology at Oxford University. He and his colleagues at the universities of Cambridge, Toronto, and Massachusetts had spent 20 years studying the phenomenal power of meditation for treating anxiety and even full-blown depression.
They had turned it into a therapy known as Mindfulness-Based Cognitive Therapy (MBCT) that was gaining the support of doctors and scientists. It had even been endorsed by the U.S. National Institutes of Health and in Britain by the National Institute for Health and Clinical Excellence (Nice).

One study, in the Journal of Clinical Psychology, has shown that it brings about long-term changes in levels of happiness and well-being, while a major study in Psychological Science revealed such changes help regular meditators live longer, healthier lives. It’s also been shown to be as effective as drugs for treating depression. In fact, it’s now one of the preferred treatments recommended by Nice.

A typical meditation session consists of focusing on breathing and the sensations it creates. This reduces the levels of stress hormones in the body which, in turn, enhances healing and boosts physical health.

It helps partly by teaching you to live in the present moment rather than worrying too much about the past or the future.

Faced with the evidence, I decided to try mindfulness meditation. I began each day with a ten-minute breathing meditation to calm the mind. At bedtime, I would meditate for 30 minutes while visualising a warm, white, healing light sweeping up and down my leg.
This simple meditation programme worked to an astonishing degree. My pain gradually subsided and I slashed my intake of painkillers by two-thirds. I also developed a more contented outlook, seeing my injuries as temporary problems that would gradually subside rather than as limb-threatening ones that might confine me to a wheelchair.

The MBCT is, I’m convinced, why I recovered in double-quick time: the leg frame was removed after just 17 weeks rather than the normal six to 18 months.

My progress astonished my doctors. Just after the final operation I joked with my surgeon that maybe my injuries hadn’t been as bad as I’d thought. He looked at me aghast and said: ‘Your leg was in the Top Five leg injuries I’ve treated with a Taylor Spatial Frame — and possibly higher.’

I still meditate for 30 minutes each day. So convinced am I by its benefits that I’ve written a book, with Professor Williams, that teaches mindfulness meditation.

And my recovery continues apace. Two years ago, at the age of 42, I took up running, and I’m currently hiking the 630-mile South West Coast Path in 50-mile sections. Given the severity of my injuries, that’s astonishing.

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Life could be like a box of chocolates

Genevieve Fox: Mindfulness is hip. It’s as trendy as yoga or zone-eating. No surprises, then, that when I enter the Oxford Mindfulness Centre (OMC), I see dawn-red soft furnishings, green plants, rubber mats and kneeling stools. Wellbeing gurus would feel right at home.

So would chocolate lovers. Mark Williams, clinical psychologist and the Centre’s director, suggests the best way to understand mindfulness is to try it and invites me to join him in a “chocolate meditation”.

Mindfulness, he says, is about being present in the moment, being aware of our thoughts and feelings – so that instead of being overwhelmed by them we are better able to manage them. Using meditation and other techniques such as breathing and yoga-based exercises, it helps us think about ourselves, and in turn others, with kindness and an overriding sense of acceptance. It’s about finding our innate joie de vivre and feeling able to cope just when we think we’re going under. It’s as irresistible as chocolate.

Prof Williams has created a series of mindfulness meditations, designed to steer us to an inner place of calm, no matter how frantic and demanding our lives. They form the basis of his new book on the topic, co-authored with journalist Danny Penman. The book offers an eight-week programme of exercises, supported by a CD and is aimed at anyone who feels depressed, unhappy or overwrought.

We start the chocolate meditation. Standing together, we each unwrap a chocolate, shut our eyes, inhale its aroma, Read the rest of this article…

then look at it and, finally, eat it. Guided by Prof Williams’s gentle voice, the world slows down as I create a pocket of space in which to enjoy a few moments of sensory awareness. I think about what I am doing; something usually rushed and unremarkable becomes a pleasurable experience. I glimpse the elation Charlie Bucket felt when he found the golden ticket.

“You enjoy the chocolate more than you would normally,” explains Prof Williams afterwards. The exercise, he says, “allows a sense of holiday atmosphere, here, right now, in the moment”.

Mindfulness may be a current buzzword but it is also eminently respectable, rooted in science and approved by Nice, the National Institute for Health and Clinical Excellence, as a treatment for clinical depression, in combination with another technique called Cognitive Behavioural Therapy. CBT helps patients manage their anxieties by challenging how they think and act; mindfulness gives them the skills to help prevent relapses of the illness.

This combined approach, called Mindfulness-based Cognitive Therapy (MBCT), was first developed in the 1990s by Prof Williams, psychologist Prof Zindel Segal of the University of Toronto, and John Teasdale, a research scientist at Cambridge University specialising in cognitive approaches to treating depression. It is the basis of the eight-week programmes Prof Williams conducts three times a year at OMC, which is part of Oxford University’s department of psychiatry; sufferers of clinical depression are referred to the centre by their GPs. During the programme, patients meet as a class for two hours a week, then follow 40-minute meditations daily for six days a week.

“MBCT is the first genuinely preventative treatment for serious depression,” says Professor Williams. Depression can be recurrent, he explains, so the aim is to teach patients in the periods when they are well the mindfulness skills they need when it returns. “MBCT has been clinically proven to halve the risk of depression in those who have suffered the most debilitating forms of the illness. It also positively affects the brain patterns underlying day-to-day anxiety, stress, depression and irritability, so that when they arise, they dissolve away again more easily.”

It is supported by clinical and scientific evidence: the latest study, published in the journal Psychiatry Research: Neuroimaging in January, found that meditating for half an hour a day for eight weeks can increase the density of grey matter in the hippocampus, the region of the brain associated with memory, stress and empathy, our ability to recognise and share others’ feelings.

The meditations in his book, designed to reach a wider audience, are shorter than those used at the Centre but, Williams explains, mindfulness practice helps both sufferers of clinical depression and those simply looking for tools to manage stress. This is because “the same patterns that keep us stuck in depression also prevent us from living a full life. We are always on our way to something. But it doesn’t take much of a shift to own the present moment,” he says.

Jeremy Lane [not his real name], 66, was never able to “own” the present moment: he was too busy worrying about both past and future. A former senior manager with a pharmaceuticals company, married with two adult children, he was for 30 years in a loop of negative thoughts – a “constant low mood”, he says. Driven, ambitious and self-critical, he was also deeply unhappy, so he pushed himself harder and the critical voice got louder.

After years of taking anti-depressants, Jeremy was referred by his GP to the OMC last year. The eight-week programme, he says, finally gave him a way of dealing with his feelings of dissatisfaction and self-loathing. “It’s made me more self-aware. I still have negative thoughts, but I step back, recognise them for what they are: thoughts, or historical things I can’t do anything about.”

Save for two brief occasions, Jeremy has managed without anti-depressants since completing the MBCT training. “It’s not a magic solution,” he is keen to stress. “If you suffer from depression it is always there, sitting in the undergrowth, ready to jump out and get you. But it’s a major plus in dealing with it.”

Many of us have a critical inner voice. It may not be as unforgiving as Jeremy’s, but it’s enough to make us unhappy, sometimes profoundly so, even when we know we’ve got everything going for us – an interesting job, a loving family, good health. And we try to talk our way out of the doldrums, often with a voice as harsh as Jeremy’s.

“We ask ourselves, ‘What have I got to be depressed about?’” says Williams. “What’s wrong with me? Snap out of it.’ It’s a brooding loop. Mindfulness gives us the resources to step outside that loop. It teaches us to objectify our thoughts for what they are: just thoughts. You don’t have to argue with them, just notice them.” The same applies to memories.

“If you think of the mind as the sky, then negative thoughts are dark clouds. It’s about learning to be with that weather, and not blaming yourself for it. It’s about seeing the mind’s patterns more clearly – and not taking them personally – and finding a place of stillness within yourself where the storm is not raging.”

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Mindfulness meditation improves well-being, researchers report

Sit down. Close your eyes. Focus on your breath. Observe your thoughts objectively as if you were a scientist.

There, you’ve achieved it: mindfulness, a heightened awareness and acceptance of the present moment without judgment.

As simple as it seems, mindfulness, with its origins in the 2,500-year-old Buddhist practices of meditation and yoga, has become the latest buzzword in wellness, as study after study confirms its power to relieve anxiety and improve mood when combined with Western therapies.

Last month University of Toronto researchers reported in the Archives of General Psychiatry that mindfulness-based cognitive therapy, which mixes mindfulness meditation with cognitive behavioral therapy, is as effective as antidepressants for preventing relapses in depression.

Dr. Zindel Segal, head of the Cognitive Behaviour Therapy Clinic at the University of Toronto, and his colleagues gathered 84 participants who had all recuperated from at least two spells of depression.

Participants were then divided into three groups. One group underwent weekly group therapy. Another received an antidepressant. The third took a placebo.

Over the span of one and a half years, 70 percent of the participants who had taken the placebo had one or more relapses of depression. Only 30 percent of those who received the therapy or the antidepressant suffered from another relapse.

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Segal believes the therapy is so effective because it teaches patients how to observe and correct the destructive ways of thinking that typically lead to depression.

“People may get criticized at work or face rejection, but this therapy teaches skills,” he said. “They can watch those negative thoughts and feelings come and go in their mind without having to engage in them. Patients can then decide to take some action which is more adaptive.”

In Chicago hospitals and private practices, mindfulness-based therapies often cater to specific conditions. Integrative Health Partners in the Loop, for example, offers mindfulness classes for those suffering specifically from anxiety, depression, physical pain and compulsive overeating.

These therapies are offered not only in one-on-one sessions, but also in couples therapy and group classes.

Chicago writer Betsy Storm completed a mindfulness-based stress reduction class last summer at Rush University Medical Center. She has continued to meditate ever since because it improved her chronic sleep problems.

“I told somebody that it was one of the best things that happened to me in 2010—adding meditation in my life,” Storm said. “I feel more alert. I’m able to relax more.”

NorthShore Evanston Hospital and the Rehabilitation Institute of Chicago offer mindfulness programming as well. Researchers are conducting studies at various universities in the area including Rush, Loyola and Northwestern.

Dr. David Victorson, assistant professor in Northwestern’s the department of medical social sciences, studies the effects that mindfulness meditation has on patients in the early stages of prostate cancer. He also runs a nonprofit called True North Treks to bring young cancer survivors together on mindfulness wilderness trips.

Many of the area’s mindfulness professionals meet monthly for networking opportunities, and annually for a teacher’s retreat. The group, called The Chicago Area Mindfulness-Based Stress Reduction Teacher’s Sangha, has about 30 members, according to founder Holly Nelson-Johnson.

She said several of the group’s members were the first to bring mindfulness-based stress reduction therapy to Chicago in the mid-90s after training with the therapy’s founder Jon Kabat-Zinn. The group later opened the first mindfulness-based stress reduction clinic in Illinois at Cook County Hospital in 1996.

Today, the group helps Chicagoans suffering from sleep deprivation, stress and anxiety. The Amsterdam-based Philips Center for Health and Well-Being recently found that Americans could use the help. In a global survey, the center found that about 49 percent of Americans reported they were too worried or stressed out to sleep.

For some, this figure may indicate that cultural values are responsible for the anxiety and stress that mindfulness-based therapies help to reduce.

“My two-year-old knows his alphabet, numbers and colors, all because of a computer,” said Vered Hankin, a mindfulness-based stress reduction therapist in Chicago. “That’s great, but you’ll learn all that eventually. But will you learn to tap into your intuition and creativity? Not if your TV or phone is always on. That’s important to remember in our society. After running around and information gathering, do we really know how to come back to the self?”

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Stressed out? Try mindfulness meditation (Toronto Globe & Mail)

Zindel Segal was in a Toronto bookstore a few weeks ago, when a title caught his eye. The book, The Mindful Investor, caused him a moment of shock and panic.

“I turned to someone and said, ‘This is the beginning of the end,’ ” recalls Dr. Segal, who heads the cognitive behaviour therapy clinic at Toronto’s Centre for Addiction and Mental Health.

The book, which purports to explain how a calm mind can help a person achieve financial security, is a sign that the concept of mindfulness is making a leap into mass popularity. But that doesn’t mean people actually understand it, he says.

Mindfulness is a technique for slowing down and examining one’s thought processes, and learning to be in the moment. Based on Buddhist principles, it became popular in the United States in the 1970s, and was taken up by celebs such as Meg Ryan and Goldie Hawn. Today, researchers are studying its benefits for everything from depression to stress.

In a multi-year study, whose results were published last month in the Archives of General Psychiatry, Dr. Segal and a group of colleagues found that mindfulness meditation – the term they use is “mindfulness-based cognitive therapy” – was just as effective as antidepressants when it came to preventing depression relapse.

Dr. Segal, who was one of the developers of the therapy, teaches it at CAMH in group treatment sessions with patients who have…

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recovered from depression and are “trying to stay well.”

“We’re seeing a demand as people feel that it’s more and more legitimate,” Dr. Segal says. He defines mindfulness meditation as “a way of training yourself to pay attention in the present moment without judgment [as] to what your experience is.”

Thanks to a similar U.K. study, which found the technique reduces the risk of depression relapse by 50 per cent, Britain’s National Institute for Clinical Excellence recommends mindfulness meditation in cases of chronic depression. The Mental Health Foundation, a U.K.-based charity, has recentlylaunched a campaign called Be Mindful, and offers an online program intended to make mindfulness more widely available.

“It’s growing exponentially almost, in terms of there now being an evidence base,” says Ed Halliwell, a British mindfulness teacher and co-author of The Mindfulness Manifesto: How Doing Less and Noticing More Can help Us Thrive in a Stressed-out World. While the field is still relatively new, some 300 to 400 studies are published each year, Mr. Halliwell estimates.

The studies show benefits for many conditions, including anxiety and stress. A study published last year in the journal Neurology found that mindfulness could be used to help people with multiple sclerosis.

And just as it is becoming more popular among researchers, it is also increasingly being sought out by busy professionals.

“Life these days is these days so full of stress … so I think this offers some way of simplifying our life,” says Marian Smith, founder of Mindful Living, a Vancouver-based clinic. Many clients, says Ms. Smith, are dealing with “the challenge of juggling full-time work, having a family, trying to make life meaningful to themselves and to be grounded.”

Doug MacLean, a mindfulness meditation instructor and owner of Practical Wellbeing in Calgary, says there has been an “explosion” in interest, in large part because of the research being published on the topic.

But some experts worry that some people may think all they need to do to solve their problems is close their eyes and pay attention to what’s going on in their heads.

“That can be a real danger, because people can go, ‘All I need to do is be mindful.’ And then perhaps they try meditation and discover it’s not easy – it’s simple, but it’s not easy – and then that can create another level of beating yourself up,” Mr. Halliwell says.

Dr. Segal says that people need to understand that mindfulness is much different than the popular idea of meditation.

“You think of the Beatles, you think of TM [transcendental meditation], you think of people achieving some kind of bliss state. And it’s really different from what people who are going through mindfulness-based cognitive therapy get,” he says. “If anything, what the meditation does is provide them with a way of staying grounded in the midst of very difficult emotions.”

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Mindfulness therapy is no fad, experts say (LA Times)

There is solid evidence that mindfulness therapy, which combines elements of Buddhism and yoga, can relieve anxiety and improve mood.

Of all fields of medicine, psychology seems especially prone to fads. Freudian dream analysis, recovered memory therapy, eye movement desensitization for trauma — lots of once-hot psychological theories and treatments eventually fizzled.

Now along comes mindfulness therapy, a meditation-based treatment with foundations in Buddhism and yoga that’s taking off in private practices and university psychology departments across the country.

“Mindfulness has become a buzzword, especially with younger therapists,” said Stefan Hofmann, a professor of psychology at Boston University’s Center for Anxiety and Related Disorders.

Mindfulness therapy encourages patients to focus on their breathing and their body, to notice but not judge their thoughts and to generally…

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live in the moment. It may sound a bit squishy and New Agey to some, but Hofmann and other experts say mindfulness has something that discredited theories of the past never had: solid evidence that it can help.

“I was skeptical at first.” Hofmann said. “I wondered, ‘Why on Earth should this work?’ But it seems to work quite well.”

Hofmann and colleagues burnished the scientific credentials of mindfulness therapy with a review article in the April issue of the Journal of Consulting and Clinical Psychology. After combining results of 39 previous studies involving 1,140 patients, the researchers concluded that mindfulness therapy was effective for relieving anxiety and improving mood.

The treatment seemed to help ease the mental stress of people recovering from cancer and other serious illnesses, but it had the strongest benefits for people diagnosed with mood disorders, including generalized anxiety disorder and recurring depression.

Jordan Elliott, a 26-year-old marketer for a New York publishing company, said mindfulness training had helped pushed his once-disabling anxiety — about work, the weather, the meaning of life — into the background. “The anxiety is still there, but it’s not as bad as it was,” he said.

Elliott started getting one-on-one therapy four years ago at the American Institute for Cognitive Therapy in New York. It was hard at first, partly because he was skeptical of the technique and partly because he didn’t feel particularly mindful. “I was such a nervous wreck I could hardly sit still for three minutes,” he said.

Now he starts every day with a 10-minute meditation. He sits cross-legged in his apartment, TV and music off, and thinks about his breathing.

“When a negative thought pops off in my head, I say to myself, ‘There’s a thought. And feelings aren’t facts.’ ”

Elliott said he was taking Prozac before he started mindfulness therapy, but he no longer needed medication to keep his anxiety under control.

“It’s pretty clear that people can improve their health if they can encourage this practice in their lives,” said David Fresco, an associate professor of psychology at Kent State University in Ohio. “But we have to be careful not to move beyond the data too quickly.”

Fresco warns that mindfulness treatment is unlikely to help someone suffering from severe and ongoing depression. Those patients, he said, need a more active approach to recovery, perhaps including antidepressants and cognitive behavioral therapy, a type of counseling that encourages patients to question the validity of their negative thoughts.

Once recovery from depression begins, however, mindfulness therapy could provide a valuable defense against future episodes, said Zindel Segal, a professor of psychiatry at the University of Toronto who was one of the pioneers behind mindfulness-based cognitive therapy, or MBCT, a treatment that combines mindfulness with cognitive behavioral therapy.

In December, Segal and colleagues published a study in the Archives of General Psychiatry suggesting that the treatment was as effective as antidepressants for preventing relapses of depression.

The study involved 84 patients who had recovered from at least two bouts of major depression. The patients were broken up into three groups: One had eight weekly group sessions of the therapy, one took an antidepressant and one took a placebo. Over 18 months, about 70% of patients taking a placebo suffered at least one more episode of depression. By comparison, only about 30% of patients receiving therapy or taking an antidepressant had a setback.

Segal said mindfulness therapy could help patients avoid rumination, the process of endlessly chewing on incidents from the past. Rumination is a driving force behind depression, he said, and it just doesn’t mesh with mindful thinking. He also believes that by encouraging patients to focus on their current thoughts, mindfulness can discourage anxiety and worry — up to a point.

“If you’re having panic attacks in the mall, mindfulness therapy on its own isn’t going to be enough,” he said.

Segal adds that mindfulness treatment changes the relationship people have with their emotions, so much so that shifts in brain activity even show up in magnetic resonance imaging tests.

“When your mind has a thought, such as, ‘My colleague just insulted me at the office,’ you can explore the consequences of that thought,” he said. “Thoughts have a less intense grip because you are an observer.”

Hofmann said most patients could pick up mindfulness fairly easily, but it’s not for everyone.

“It takes quite a bit of intelligence,” he said. “It’s good for people who like intellectual stimulation.”

In addition, children, older people (who tend to be more set in their ways) and rigid thinkers may have trouble understanding or embracing the treatment, he said.

Hofmann hopes that the ongoing flood of mindfulness studies will help clarify the benefits and limitations of the approach and ultimately shape the way that the therapy is offered in the real world.

“Some therapists embrace these new and sexy treatments without a lot of critical thinking because they sound cool,” he said.

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