Addiction A-Z

Mindfulness-based therapy

Considering the overwhelming pace of society today, it’s no wonder that anxiety and depression are two of the most prevalent problems for which physicians write prescriptions. Many people feel increasing pressure to multi-task constantly, less an urgent task gets overlooked. Doing this makes it impossible to really focus on any one thing. It also makes it virtually impossible to be truly present in the moment. Additionally, many people find it very difficult to let go of past regrets and hurts, or refrain from excessive fretting about what their future holds. Not only does this inability to live in the present rob them of happiness, it keeps them from living life fully. Learning to be mindful beautifully addresses these – and many other – troubling issues.

Mindfulness refers to being aware of your thoughts, feelings, and experiences in the present moment, and accepting them without judgment. Rather than habitually reacting to stressful situations, unwanted thoughts, or unpleasant feelings, it enables you to be a compassionate, accepting, and non-judgmental observer of them. Practicing mindfulness – and it does take practice, as it’s often quite challenging at first – helps quiet the internal chatter. This makes it much easier to calmly cope with challenges that previously seemed overwhelming.

Mindfulness-based therapies and methods are becoming increasingly popular with mental health and other healthcare professionals. Most mindfulness therapies incorporate elements of more traditional types of therapy, such as cognitive behavioral or Gestalt therapy. However, with the unique and powerful addition of mindfulness techniques, these therapeutic approaches can be particularly beneficial in the treatment of a vast array of disorders and conditions. Although research is continuing to be done in this area, there have already been countless studies to support the use of specific mindfulness methods and mindfulness-based therapies.

Mindfulness Meditation

One of the most common and effective ways to teach mindfulness is the use of mindfulness meditation. Therapy clients are taught to quietly focus on nothing but the present moment. Most people find this very difficult at first, as it’s normal for the mind to quickly start wandering in multiple directions. With mindfulness meditation, the goal is to simply notice and accept those distracting thoughts without judging or labeling them as good or bad, positive or negative, and then bring the focus back to the present.

During mindfulness meditation, the thoughts that come up often elicit certain emotions (e.g. sadness, fear, or joy) and physical reactions (e.g. muscle tension or more shallow breathing). Therapy clients are instructed to take note of those feelings and sensations, as well as the particular thoughts that trigger them. By remaining an impartial observer in the moment, they learn to accept – rather than react to – the thoughts.

Mindfulness meditation can be done formally (e.g. sitting in quiet meditation, or engaging in a form of mindful movement, such as yoga or walking meditation) or informally (i.e. consciously practicing mindfulness throughout your day to day activities).

Over time, practicing mindfulness fosters emotional healing. It greatly enhances self-awareness and insight, making it much easier to stay in the present moment, quiet the mind, and handle stressful situations more calmly and effectively.

History of Mindfulness-Based Therapies

Although mindfulness-based practices, such as meditation, have been around for centuries, most mindfulness-based therapies have been around for just a few decades. There are several names associated with the development of mindfulness-based therapies.

One of the earliest pioneers in the area of mindfulness-based therapy was Japanese psychiatrist Shoma Morita. He developed his eponymous treatment approach, Morita Therapy, over 90 years ago. Morita therapy is based largely on mindfulness principles from Dr. Morita’s extensive training in Zen meditation.

Perhaps one of the most prominent contemporary names in mindfulness-based therapies is Canadian psychiatrist Zindel Segal. Dr. Segal, along with colleagues J. Mark G. Williams and John Teasdale, developed Mindfulness-Based Cognitive Therapy (MBCT). Dr. Segal has written several books on the topic, including Mindfulness-Based Cognitive Therapy for Depression (published in 2002) and The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness (published in 2007 and co-authored by Jon Kabat-Zinn, Mark Williams, and John Teasdale).

Another prominent name in mindfulness-based therapeutic approaches is Jon Kabat-Zinn. Dr. Kabat-Zinn hails from New York and obtained his PhD in molecular biology from MIT in 1971. While at MIT, he attended a lecture on meditation that had a profound influence on the direction of his life.   He initially studied, and then later taught, at the Insight Meditation Society in Massachusetts.

Dr. Kabat-Zinn developed the popular 8-week Mindfulness-Based Stress Reduction (MBSR) program. He also founded the Stress Reduction Clinic, as well as the Center for Mindfulness in Medicine, Health Care, and Society. Both are located at the University of Massachusetts Medical School, where he is currently a professor emeritus.   Dr. Kabat-Zinn has authored several books on the topic of mindfulness, including Mindfulness for Beginners: Reclaiming the Present Moment – and Your Life (published in 2011). Variations of MBSR have been used in a variety of settings, including hospitals, schools, prisons, and programs for veterans.

Two other important contributors to mindfulness-based therapies are J. Mark G. Williams, a professor of psychology at Oxford University, and John Teasdale, a prominent researcher at Oxford University’s Department of Psychiatry. As mentioned above, they both played major roles in the development of mindfulness-based cognitive therapy.

Dr. Marsh Linehan is another important contributor to mindfulness-based therapies. A psychologist and practitioner of Zen meditation herself, she was one of the first to incorporate mindfulness concepts into the treatment of borderline personality disorder. Dialectical behavior therapy, created by Linehan and her colleagues at the University of Washington in the 1970s, is widely used today.

One other name worthy of mention in regards to mindfulness therapies is Bruno Cayoun. Dr. Cayoun is an Australian psychologist who developed Mindfulness-Integrated Cognitive Behavior Therapy (MiCBT). Since 2004 he has been teaching his mindfulness approach to clinicians in Australia, as well as Singapore, Hong Kong, and New Zealand. He has developed training CDs and has also authored two books on the subject: Mindfulness-integrated CBT: Principles and Practice (published in 2011) and Mindfulness-integrated CBT for Well-being and Personal Growth (to be released in 2015).

Types of Mindfulness-Based Therapies and Programs

There are actually several different therapies and programs that incorporate or are based upon mindfulness.

Mindfulness-Based Stress Reduction (MBSR)This mindfulness-based intervention is comprised of an intensive 8-week program that essentially combines mindfulness meditation, yoga, and psychoeducation. Meditation helps alleviate stress and can benefit many different bodily processes, such as reducing blood pressure to more normal levels. Yoga helps offset the negative impact of getting little to no exercise, which is so typical in today’s society. Physical and mental self-awareness are enhanced – and stress is significantly reduced – when both meditation and yoga are practiced simultaneously.

It’s important to note that MBSR is not actually a form of therapy. Rather, it’s considered a form of “participatory medicine” and has more of an emphasis on education participants. It’s often used in conjunction with – rather than in place of – other forms of treatment (e.g. medical treatment or psychotherapy).

Mindfulness-Based Cognitive Therapy (MBCT) – This mindfulness therapy was developed to help individuals who struggle with recurrent episodes of depression. It essentially combines the tenets of traditional cognitive behavioral therapy (CBT) with mindfulness meditation and other mindfulness strategies. MBCT helps individuals with depression become less reactive to thoughts and feelings that would typically cause distress. It can be very beneficial in helping reduce and prevent future bouts of depression.

Mindfulness-Integrated Cognitive Behavioral Therapy (MiCBT) MiCBT shares many similarities to MBCT. However, they are not the same therapies and were designed for different purposes. Like MCBT, MiCBT combines aspects of CBT with mindfulness principles and techniques. MiCBT is a 4-stage treatment model that can be used to treat a variety of disorders, both acute and chronic. The 4 stages are personal, exposure, interpersonal, and empathic. Treatment typically lasts between 8 and 12 sessions.

Acceptance and Commitment Therapy (ACT) – ACT is rooted in traditional behavior therapy. It focuses on teaching people to accept and be mindful of negative thoughts and emotions – rather than constantly trying to eliminate or avoid them, which creates more suffering. Being mindful enables them to more effectively make the positive changes they desire.

Dialectical Behavior Therapy (DBT)Dialectical behavior therapy effectively combines Eastern mindfulness practices, dialectical philosophy, and cognitive behavioral principles. It was originally designed to treat individuals with borderline personality disorder, a particularly challenging disorder to treat with any substantial degree of success. Dialectical behavior therapy is comprised of four treatment modules: core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.   Today, DBT is used to treat depression, anxiety, and many other psychiatric disorders, in addition to being one of the most effective therapies for borderline personality disorder.  

Hakomi Therapy – This mindfulness approach was developed by Ron Kurtz back in the 1970s. It focuses on the principles of mindfulness, nonviolence, unity, organicity, and mind-body integration. Hakomi therapy combines elements of multiple philosophies and treatment approaches including Gestalt therapy, neuro-linguistic programming, Ericksonian hypnosis, Taoism, and Buddhism.  

Mode Deactivation Therapy Developed by psychologist Jack Apsche, mode deactivation therapy combines key characteristics of CBT, DBT, and ACT with mindfulness strategies. It is geared towards helping troubled teens with a history of trauma and behavioral problems.

Morita Therapy Dr. Shoma Morita originally developed this therapeutic approach to treat a neurotic disorder known in Japanese culture as shinkeishitsu. Individuals with the disorder struggle with intense perfectionism, obsessive thoughts, hypochondria, and social anxiety. Like ACT, Morita therapy teaches people to accept their thoughts and feelings – rather than trying to “fix” them – while focusing on living life fully and with purpose.

Disorders, Issues, and Conditions that can benefit from Mindfulness-Based Therapeutic Approaches

Mindfulness-based therapies and techniques have been effectively used to treat many different psychiatric disorders, symptoms, conditions, and issues related to physical health problems. In fact, learning to be mindful can be psychologically beneficial for essentially any challenge that life presents. Learning to be mindful is a process; it doesn’t happen overnight. However, those who practice it regularly typically experience a greater sense of control when attempting to cope with difficult situations.

Following are several disorders that often respond very well to mindfulness-based therapies:

Depression –Recurrent episodes of depression are common in many individuals diagnosed with major depressive disorder. Mindfulness-based cognitive therapy was designed with this in mind by helping reduce this occurrence.

Mindfulness based approaches are particularly helping in reducing the brooding or rumination that’s one of the hallmark symptoms of depression. Once depressed individuals start brooding they find it very difficult to let go of the sad, negative thoughts. By increasing their self-awareness, mindfulness helps them recognize the brooding and allow the thoughts to pass instead. It also helps depressed individuals become more compassionate to both themselves and others.

Anxiety – Mindfulness approaches are particularly well-suited for the treatment of anxiety disorders. Individuals with battle anxiety have a difficult time letting go of troubling thoughts. They often fail to distinguish unproductive “what if” thinking from effective problem-solving. Mindfulness enables them to recognize worrisome thoughts as merely thoughts – rather than facts. By looking at the thoughts from this detached perspective, it takes away the power those thoughts previously held. Research has shown that individuals with generalized anxiety disorder respond well to mindfulness-based stress reduction.

PTSD / Trauma Recovery – Mindfulness-based stress reduction has been shown to provide positive benefits to military veterans suffering from posttraumatic stress disorder. Not only can MBSR help veterans improve in terms of self-acceptance, it can also help reduce the symptoms of depression, such as rumination, that often accompany the trauma-induced disorder.

Although the research is limited in this area, a 2013 study showed that mindfulness-based cognitive therapy may also be a helpful short-term intervention for veterans with PTSD when used in a group therapy format.

Obsessive-Compulsive Disorder (OCD) – Dr. Jeffrey Schwartz, one of the leading authorities on the treatment of OCD, has effectively combined Buddhist mindfulness techniques in his treatment methods. Individuals with OCD have a very difficult time staying in the present, which is one of the key tenets of mindfulness approaches. They frequently get deeply mired in worrying about the future or focused on fretting about the past. The present is often the farthest thing from their mind. They also get stuck on the intrusive thoughts that pop into their minds, giving them far more merit than they deserve. By diligently practicing mindfulness techniques, individuals with OCD can learn to keep intrusive thoughts in perspective and stay more focused in the present moment.

Addiction and Recovery – It’s a well-known fact that stress is a major contributor to substance abuse and addiction. It’s also a common trigger for relapse following drug and alcohol rehab. Those who struggle with addiction can learn to develop new responses to both cravings and stress by practicing mindfulness. As they learn to accept – rather than judge – unwanted thoughts or feelings – they are less likely to simply react by reaching for their drug of choice. As with smoking, the self-awareness that mindfulness brings can also help reduce the tendency to use when cravings strike.

Eating Disorders – Mindfulness-based therapy can be very effective in helping individuals who battle eating disorders – particularly binge eating disorder and bulimia. Disordered eating is often exacerbated by stress and negative self-talk. Learning to accept oneself with compassion rather than judgment can help reduce maladaptive behavior. An increasing number of eating disorder treatment programs are incorporating mindfulness therapy and / or methods into their treatment protocol. Jean Kristeller, Ph.D., a professor emeritus of psychology at Indiana State University, developed Mindfulness-Based Eating Awareness Therapy (MB-EAT). It’s based on the tenets of MBSR. It helps people become more self-aware of emotional triggers for eating, genuine hunger cues, and signals that they’re full.

Weight Management – As witheating disorders, mindfulness-based treatment is beneficial for both weight loss and weight management. Meditation can help manage stress, which is a common trigger for emotional overeating.Mindfulness can also help reduce negative emotions and the habitual tendency to reach for food whenever they occur. Psychologists who participated in a 2012 survey by Consumer Reports listed mindfulness training as one of the more effective approaches to losing weight.

InsomniaMany people who struggle with insomnia have a difficult time “shutting off” their mind as they try to fall asleep. Mindfulness-based techniques help insomniacs become aware of the physical sensations and mental activity that may be keeping them awake. Using the meditation technique of simply focusing on their breath – while refraining from judging any thoughts that come up and consciously noting and releasing physical tension – helps promote a state of relaxation that is conducive to sleep.

Take the attitude of an impartial observer to any thoughts that may arise. Aim to remain focused on your breathing. Thoughts may, at times, distract you from your practice. If this happens simply, gently, bring your focus back to your breath.

Smoking Cessation – In 2007, a pilot study was conducted to determine whether or not a slightly modified version of mindfulness-based stress reduction could help smokers. The results were positive, indicating that meditation helped decrease both stress and emotional distress, and contributed to abstinence from smoking. A mindfulness also approach helps smokers stop associating their cravings with smoking.

Distress associated with Cancer – Mindfulness-based therapy and techniques has been shown to be beneficial in decreasing the negative thoughts and emotions that often go hand in hand with a diagnosis of cancer.

Benefits of Mindfulness-Based Therapy

There are multiple benefits to mindfulness approaches and techniques in all areas of life, including mental health, physical health, relationships, and overall wellbeing.

Decreased rumination and other depressive symptoms – As mentioned above, mindfulness techniques such as meditation help reduce depressive symptoms, such as brooding and negative emotions. Individuals with depression often get stuck in regrets about the past and a dismal or even hopeless view of the future. Mindfulness helps them stay focused on the present.

Decrease in emotional reactivity Emotional overreactions often cause problems in relationships, work settings, and other life situations.   Research has shown that practicing mindfulness meditation can help people become less emotionally reactive to upsetting images.

Improved focus – Individuals who have difficulty staying focused are often easily distracted by both internal (e.g. worries, random thoughts, negative emotions) and external factors (e.g. noise, nearby activity). Practicing mindfulness meditation has been shown to increase their ability to focus on the task at hand and ignore distractions.

Improved relationships – Research has shown that mindfulness helps mitigate the negative emotional impact of conflicts in relationships, leading to greater relationship satisfaction. It also helps people establish more meaningful connections with others. Practicing mindfulness meditation can be beneficial for couples struggling with conflicts in their relationship.

Enhanced working memory – A 2010 study found that mindfulness meditation improved working memory in military subjects who had been experiencing significant stress prior to deployment.

Greater life satisfaction – Learning to become more mindful can increase an overall sense of satisfaction with life. Being mindful – and thus fully present in the moment – increases the ability to truly appreciate life’s joys and participate more fully in activities. It also improves people’s ability to handle adversity.

Less anxiety– Individuals who practice mindfulness are less likely to feel anxious and worried. They’re also better equipped to let go of past regrets.

Other psychological benefits of mindfulness include:

  • Greater self-awareness and insight
  • Stress reduction
  • Increased intuitiveness
  • Increased ability to accept – rather than habitually react to – unwanted thoughts and feelings
  • Greater clarity
  • A greater sense of balance in life
  • Increase in creativity
  • Improved ability to handle challenges effectively
  • Overall decrease in negative emotions

Physical health benefits of mindfulness include:

  • Stronger immune system
  • Better sleep
  • Improved digestion
  • Decrease in chronic pain
  • Lower blood pressure
  • Less frequent doctor visits

Where to Find a Mindfulness-Based Therapist

Since there are numerous types of mindfulness therapies, many therapists can be located by searching for the specific type of therapy online (e.g. “DBT therapy [your city]”). However, searching for “mindfulness therapy [your city]” should also bring up multiple providers as well. Their websites should clarify the specific mindfulness approach they practice, such as mindfulness-based stress reduction or mindfulness-based cognitive behavioral therapy, for example.

When searching for a therapist, make sure that he or she has the appropriate training and certification (if relevant) to practice the respective type of therapy.   Most practitioners offer a free consultation to determine if the type of therapy they offer is a good fit for prospective clients.

Even if you don’t have a mental health disorder, learning to practice mindfulness from a skilled clinician can greatly enhance your life. Not only will mindfulness strategies help reduce the stress in your life, they will also enable you to truly appreciate the present moment and live your life to the fullest.

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