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Friday 14 April 2017

Staying in the Moment: Mindfulness and Conscious Appreciation



“There is only one time that is important— Now! It is the most important time because it is the only time when we have any power.”                                                                               
                                                                                                                                           Leo Tolstoy (Author)


We have already been talking a lot about mindfulness and I thought that it would be a good idea to have a separate post on this to provide a little bit more information about this topic.

What is mindfulness?
Mindfulness can be defined as paying active attention to present moment experiences (including mental/emotional experiences and body sensations) with a compassionate, open and accepting attitude.1 This focusing of the mind can be cultivated or ‘trained’ in different types of mindfulness meditation practices. However, mindfulness does not require meditation; it can also be practiced in daily life by staying in the moment, which includes the conscious savouring of pleasant experiences as well as non-reactive observation of difficult experiences.1-3,5
The type of mindfulness meditations we are talking about today are secular meditations, although the exercises have been historically derived from ancient (manly Buddhist and Yoga) contemplative practices.1,3,4,6 There are several different types of mindfulness meditations, with the most commonly practiced meditations including:
  • Breathing meditation- simply concentrating on the sensations experienced during inspiration and expiration
  • Body scan- systematically exploring every region of your body with the mind
  • Sound meditation- focusing on the sounds occurring in the environment during the meditation
  • Thought observing meditation- observing your thoughts as they come and go without becoming engaged with them
  • Working with difficulties- exploring difficult situations or memories, thoughts and feelings while staying detached and non-reactive
  • Loving-kindness meditation- cultivating feelings of warmth and caring towards others and yourself.

In addition to mindfulness meditations, there are various present moment awareness exercises, which can focus on pleasurable body sensations (e.g. mindful eating) or other positive experiences.1,2,5
Over the last decades, many specific mindfulness-based therapies have been developed and tested for their efficacy. These include mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT),1,6 combining elements of psychotherapy with mindfulness meditations. MBCT has been shown to be very effective in treatment of depression.1,3

Benefits of mindfulness
There is a solid body of scientific evidence that mindfulness practice is beneficial in many circumstances. Benefits of mindfulness include:1,3-7
  • Regular meditators report themselves to be happier and more content. 
  • Mindfulness improves emotion regulation and increases mental and physical resilience. 
  • Improved interpersonal relationships
  • Improved memory, reaction times
  • Reduction in anxiety, depression, hypertension and stress; reduction of chronic pain

One reason why mindfulness is effective is simply because it teaches us to focus our mind on the current moment.1,7 Mind-wandering is very much a normal process in our human brain, but it has been demonstrated that mind-wandering is associated with unhappiness, and that people who are more able to focus on present moment activities are happier (even if the activities are not necessarily pleasant).8 But mindfulness does more than merely stopping mind-wandering. Studies have shown that people who regularly meditate have an increased activity in certain brain areas, including the prefrontal cortex, the insula and the hippocampus, areas which are essential for emotion regulation, self-awareness, compassion/self-compassion, learning and memory.1-3,7,9 If regularly practiced, mindfulness allows us to become less reactive to our thoughts and emotions, as we realize that feelings and thoughts come and go, and that they do not define us as a person. By not identifying with our thoughts, we gain the freedom not to act on them.1,3 Mindfulness also makes us become more aware of our automatic thoughts and negative thinking patterns.1
Furthermore, consciously savouring positive experiences can help us to counteract the negativity bias:2,7 You may remember from previous posts, that most of us tend to notice and remember negative events more readily than positive ones, and that we also often interpret events in a negative way, even though many events are in fact neutral. Although the negativity bias is completely natural, it can decrease our well-being; particularly in stressful situations, we stop noticing the many good things in life- either because we completely overlook the positive events or because we only pay fleeting attention to them. So, if you are consciously focusing your attention on the moment, you are more likely to notice a positive experience when it happens. Furthermore, it matters for how long you hold positive experiences in awareness: the longer you are able to focus on a pleasant experience, the more likely it is to make a lasting beneficial effect on you.2

Learning to be mindful
Mindfulness practices are not difficult but as with learning any new skill, some commitment and discipline is required. Different ways of training are available, ranging from mindfulness classes (including MBSR and MBCT), online courses, books, magazines, podcasts and apps. Intensity, length of meditation/practice sessions and type of exercises vary, and it should be possible to find a suitable type for everybody. However, the quality of the mindfulness training may also be very variable and it is advisable to do some basic research about your chosen training- e.g. about the qualification of the teacher(s) providing the training, if the chosen course suits your circumstances/needs, and whether the efficacy of the offered techniques has been assessed.

Limitations and potential risks of mindfulness
Although mindfulness exercises have been shown to be very beneficial to many people, it may not work for everybody. If you have tried mindfulness practices and found them unhelpful, there may be several reasons for this- of course it could mean that mindfulness is not for you but it could also be that you have simply not given yourself enough time to practice, or it may be that the type of mindfulness meditation/way of practice has not been the right one for you, or that you have not found the right meditation teacher/instructor. It has to be considered that most studies about the usefulness of mindfulness have been conducted with structured mindfulness courses and provided by suitably trained mindfulness teachers, so statements about efficacy cannot necessarily be transferred.

It is also important to realize that mindfulness is not a panacea- it can be a huge help, but it is not the only way of increasing our well-being or dealing with difficult situations. As discussed in the posts ‘Dealing with the Darker Days’, there are situations where you need to look into changing your life situation (mainly if you are experiencing events triggering helpful negative emotions). In these circumstances, mindfulness is an aid to preventing a downward spiral of negativity and helping you to stay creative and effective in finding a solution, but it is not the solution itself.10 Also, if you consistently find that mindfulness meditations are not working for you, then the more practical moment awareness exercises, walking meditation, progressive muscle relaxation, deep breathing exercises, Tai Chi or Yoga may be some alternative techniques you could try.3,11  

Mindfulness is generally regarded as a safe type of mental training.1-7 However, due to the nature of some of the exercises it is of course possible that painful thoughts and feelings may emerge during the practice. There have also been rare reports of harmful effects of mindfulness practice ranging from panic to psychotic symptoms.12 However, harmful effects are more likely to occur in vulnerable individuals (meditation participants with pre-existing mental health issues) and/or in participants of intensive training sessions, such as a meditation retreat over several days.12 Although the topic of potential negative effects of mindfulness practice requires further research, lower- to medium-intensity exercises, such as self-help books, podcasts, apps and mindfulness classes guided by an experienced teacher are thought to be unlikely to result in any harmful effects.12 However, if you are affected by mental health difficulties, it is particularly important to seek a suitably qualified and experienced mindfulness teacher, and to make sure that the mindfulness training program is evidence-based.

Conclusion
Mindfulness has been consistently shown to be helpful in many circumstances, and can potentially increase our quality of life significantly. One reason why mindfulness is so effective has been beautifully described by Leo Tolstoy in above quote: we have only power in the now. By concentrating on the current moment we can not only free our mind from the suffering associated with painful memories and the worried anticipation of the future, but by concentrating our efforts on the current moment, we can also become more effective and creative in the present. However, as with any technique, there are limitations to mindfulness and it may not work for everybody. Before signing up a to a mindfulness program, It is highly advisable to do some research.


Some mindfulness practice resources:


Mindfulness by Mark Williams and Danny Penman is a great introduction into mindfulness. Mark Williams is Professor of Clinical Psychology at Oxford University and has co-developed MBCT. The book contains an 8-week mindfulness program with various meditations and practices, and also provides some more detailed background information about this topic.

Free meditation podcasts are available from the Mindfulness Awareness Research Centre of the University of California Los Angeles: http://marc.ucla.edu/mindful-meditations

Preview: Next week we are going to look at one of the most central questions of well-being: finding meaning in our life

References and further evidence-based reading:
1. Williams M, Penman D. Mindfulness: A Practical Guide To Finding Peace In A Frantic World. Hachette Digital Little, Brown Book Group; London, UK. 2011.
2. Hanson R: Hardwiring Happiness: How to reshape your brain and your life. Rider Ebury Publishing, Random House, UK. 2013. 
3. Siegel D. Mindsight: Transform Your Brain with the New Science of Kindness. Oneworld Publications; Oxford, UK. 2011.
4. Kok BE, Singer T. Phenomenological fingerprints of four meditations: Differential state changes in affect, mind-wandering, meta-cognition and interoception before and after daily practice across 9 months of training. Mindfulness. 2017;8:218–231.
5. Nasser JD, Przeworski A. A Comparison of Two Brief Present Moment Awareness Training Paradigms in High Worriers.
6. Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytical review. J Consult Clin Psychol. 2010;78(2):169–183.
7. Seppälä E. The Happiness Track: How to Apply the Science of Happiness to Accelerate Your Success. Piatkus; London, UK. 2016.­­
8. Killingsworth MA, Gilbert D. A wandering mind is an unhappy mind. Science. 2010;330:932.
9. Hölzel BK, Carmody J, Vangel M, Congleton C, Yerramsetti SM, Gard T, Lazar SW. Mindfulness practice leads to increases in regional brain matter density. Psychiatry Res. 2011;191(1):36-43.
10. Fredrickson B. Positivity: Groundbreaking Research to Release Your Inner Optimist and Thrive. Oneworld Publications; Oxford, England. 2010.
11. Pittman CM, Karle EM: Rewire Your Anxious Brain: How to use the neuroscience of fear to end anxiety, panic & worry. New Harbinger Publications;­­ Oakland. 2015.
12. Baer R, Kuyken W. Is mindfulness safe? 2016. Retrieved from http://oxfordmindfulness.org/insight/is-mindfulness-safe/  


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