Introduction
Mindfulness is a philosophical concept that is broadly defined as a psychological practice of purposefully focusing one’s attention on an ongoing experience (Kabat-Zinn, 2013). While not intended for clinical use, it was eventually utilized for addressing numerous mental health disorders, such as substance abuse, anxiety, and depression. The following scholarly paper aims at exploring the practice of mindfulness and determining its value both as a component of mental health and wellness interventions as well as means of overall improvement of personal and professional life.
Theory and Philosophy of Mindfulness
The concept of mindfulness is present in some form in the philosophical movements of many cultures. However, its current iteration is commonly associated with Eastern Buddhist tradition (Ie, Ngnoumen, & Langer, 2014). Despite significant mutual penetration and influences, several key differences still exist between the Eastern and the Western perspectives that need to be acknowledged to understand the theory and its underlying philosophical principles.
In Eastern philosophy, mindfulness (sati) originally means “memory” (Ie et al., 2014). However, the core concept is closer to awareness, or conscious perception. It is viewed as one of the essential components of the Eightfold Path used to alleviate suffering. The suffering deserves a closer look since it is also different from the core problem of the Western world. In scholarly Buddhist literature, suffering is not limited to physical conditions such as aging, disease, pain, and death, but also includes the issue of not obtaining the desired result. Thus, the issues range from chronic pain to the stress from the loss of a close relative. Also, the common cause of the problem is craving – the desire to attain a certain object, emotion, or state that is perceived as favorable.
It is important to recognize the innate origin of the problem – while the agent that triggers the suffering is external, the root cause is internal, as is the preferred intervention. Specifically, the Buddhist doctrine suggests resorting to Right Mindfulness (alongside other components of the Eightfold Path such as Right Action and Right Thinking) and thus minimize craving. This is traditionally done by cultivating acceptance of the inevitability of diverse experience, self, and the surroundings, and is accompanied and assisted with sets of meditative practices. In other words, the Eastern approach is focused on a single cause of unsatisfactory experience and provides a single solution (in the form of acceptance) through a universal practice (including, but not limited to, mindfulness).
From the Western standpoint, the problem lies in the poor decisions made due to insufficient (or lacking) comprehension of the issue. The most common cause of such decisions is mindless acceptance of unfounded but well-known misconceptions and stereotypes or uncritical compliance with authority. Therefore, the cause can be characterized as the excess of compliance with the environment and the preference for obsolete and inadequate standards (Ie et al., 2014). Such an approach is acceptable on the basic biological level (from the evolutionary standpoint) but poses a considerable threat when applied to social and cognitive aspects of existence.
The said barriers to mindful decision-making may originate from within (as the person perceives the abundance of alternatives stressful and shields from them to avoid anxiety) or come from the outside (either misinterpreting the neutral clues from the environment or as a result of the deliberately misleading actions of the peers). To avoid such downfalls, an individual needs to constantly and consistently challenge his or her existing beliefs, behaviors, and attitudes. Such a critical approach is expected to ensure not only an unbiased, objective worldview but also provide a clearer vision of self. Such an approach also inevitably leads to the decline of the absolutist approach and the emergence of multiple perspectives.
To sum up, the Eastern perspective views mindfulness as a purely innate process that is universal, singular, and emerges as a state of existence. The Western perspective, on the other hand, suggests its active nature (conscious cognitive challenge) and views mindfulness as a driver fueled by the sense of purpose.
Description of Seven Pillars
To attain mindfulness, one needs to form a basis of attitudes that would promote the desired state. Jon Kabat-Zinn (2013) identifies seven such attitudes and terms them “pillars of mindfulness.”
Non-Judging
As was explained above, the fundamental cause of poor decisions made by individuals is the presence of preconceived notions, beliefs, and judgments. Human beings are evolutionarily predisposed to automatize the decision-making process to minimize the amount of time and resources necessary for each action. To achieve the simplicity of attitudes, humans also resort to labeling the phenomena as positive or negative. According to Jon Kabat-Zinn (2013), this effect eventually creates anxiety and deprives people of the sense of balance and peace. To minimize its effect, humans need first to gain awareness of the automatic nature of their judgment, which can be achieved by suspending it and reaching the state of impartiality. Once this state is achieved, the following events should be approached with suspended judgment.
Patience
The highly dynamic nature of the modern world leads to the necessity of keeping up the pace with the surrounding events. Eventually, the ability to achieve the result in the shortest time becomes associated with a positive outcome and, by extension, the inability to speed things up creates a perception of inefficiency regardless of the actual possibility to do so. Understandably, such a setting creates anxiety and stress. To avoid the perceived inefficiency, the practitioners need to consider the ever-present value of life in each moment. In other words, they need to accept the necessity and inevitability of each moment and avoid wavering between the desired future states and the lived experiences of the past, concentrating on the present entirety.
Beginner’s Mind
To attain a new perspective on the environment and the accompanying experience, a person should consciously approach the issue in a manner that resembles the first-time experience. In addition to the freedom from the preconceived notions, such an approach allows for greater openness to knowledge. As a result, he or she may become more receptive to new information and avoid the assumption of expertise which is often overrated and may disrupt the learning process.
Trust
Even though meditative practices are often assisted by an instructor, one of the fundamental premises of attaining mindfulness is independence from authority. Therefore, one of the necessary conditions is gaining trust in one’s feelings. The concept of awareness and conscious decisions rests on the premise of a strong authority of self. Therefore, the desirable direction a person must take is away from the decisions of others and towards the acceptance of one’s value. This pillar should be approached with the acceptance of new knowledge in mind, i.e. it does not necessitate the rejection of alternatives but promotes individual responsibility and empowerment.
Non-Striving
Unlike the Western approach to mindfulness, which is based on active effort, the meditative practices require non-action as their core mechanics. Essentially, since mindfulness is intended to promote the awareness of self, it becomes more effective with the decrease of the effort spent on it. So, to achieve the desired outcomes, a person must find a way to let go of the expectations of reaching it and instead accept the experience as it is, making it similar to deconstruction.
Acceptance
According to Kabat-Zinn (2013), the period of calmness and peace that follows the period of anxiety can be explained by the eventual acceptance of the undesirable event. However, what leads to it is the emotional exhaustion that prevents us from resisting the event. To avoid the inefficient and unfruitful intermediary phase, we need to learn to consciously accept the experience as is. To do this, we first need to identify our emotions, determine their effect on our lives, and try forgoing those which distort our perception of reality.
Letting Go
Human consciousness tends to selectively store experience that is considered functionally or emotionally valuable. While practically useful, this trait also creates several limitations, such as the inability to relax, the tension associated with persistent memories, and judgment. Therefore, to avoid restrictions, meditation practices require developing the skill of distancing from any given thought. Over time, this approach will result in the ability to break away from attachments and reach ultimate independence. Ultimately, letting go allows practitioners to accept the existing state of events easier.
Health and Wellness Benefits
Mindfulness has been actively incorporated into numerous wellness-oriented programs, with varying degrees of success. A growing body of literature identifies its benefits for both focused interventions and large-scale initiatives. Various professional and educational fields associated with high levels of stress are among the areas where the utilization of mindfulness is highly desirable. The preliminary data from a pilot study by Danilewitz, Bradwejn, and Koszycki (2016) evaluated the possibility of introducing a mindfulness meditation program to pre-clerkship students of medical schools, which are associated with a significant academic load. The results identified improvements in several areas of student performance, including homework compliance, program attendance, self-compassion, psychological distress, and empathy (Danilewitz et al., 2016).
Also, all students reported a high interest in the possibility of participation and expressed satisfaction with the perceived results. Similar results were observed in a study by Erogul, Singer, McIntyre, and Stefanov (2014), which measured a psychological condition of participants using perceived stress scale (PSS), self-compassion scale (SCS), and resilience scale (RS) after incorporating an abridged MBSR intervention. The results included significant improvement of SCS score, a reduction in PSS score, and an insignificant improvement in RS score which, nevertheless, correlated with the rest of the findings (Erogul et al., 2014). It should be acknowledged that these results are replicable throughout the academic field, with evidence of mindfulness being generally beneficial for students’ well-being, engagement, and academic performance (Wisner, 2014).
Mindfulness is also a fairly popular intervention for use in the workplace. Several specific mindfulness-based interventions (MBI) were developed to provide employers with efficient tools compliant with time restrictions posed by working conditions. One such intervention, Mindfulness in Motion (MIM), has been successfully implemented and tested in several countries. The workers subjected to the eight-week MIM program report significant stress reduction increased subjective sleep quality, as well as an overall improvement of global sleep, daytime dysfunction reduction, and a slight improvement in work absorption (Klatt, Norre, Reader, Yodice, & White, 2016). Importantly, the program demonstrates the feasibility of cross-cultural application since the mentioned results were demonstrated outside the initially intended cultural setting.
On a broader scale, mindfulness can be used to achieve wellness enhancements in non-specific adolescent groups, which, in turn, will allow for mental and physical health improvements (Johnstone et al., 2016). According to Hudziak (2016), mindfulness combined with yoga and fitness training is expected to contribute to better emotional regulation, improved attention, and an overall decrease in several undesirable effects, such as depression, anxiety, and suicidal mood. Broderick and Frank (2014) argue that mindfulness remains an optimal intervention for the young population due to several advantages over the alternatives.
Specifically, it is characterized by simplicity which is expected to attract children and youth, is consistent with the necessity for identification pertinent to adolescents, and creates a valuable approach that can be utilized throughout life, especially in the case of early adoption of the technique. The BREATHE intervention program developed by the authors yielded positive results for students upon its integration in the school curriculum. The outcomes included greater distress tolerance, improvements in cognitive skills required for academic performance, and better self-regulation, among other things (Broderick & Frank, 2014).
It is worth mentioning that while most of the studies focus on specific outcomes associated with wellness among the specific sample population, some evidence suggests that the influence of mindfulness-based interventions reaches beyond the scope of the target group. In a study by Tobin, Powietrzynska, and Alexakos (2015), a long-term education program for science teachers of Brooklyn College resulted in improved quality of life among the participants, involved researchers, and individuals with whom the participants interacted during the research. Interestingly, the authors also identified several changes in the curricula developed by the participants as well as the curricula of affiliated organizations exposed to the influence of the program (Tobin et al., 2015). While the latter cannot be conclusively verified, it aligns well with the sustainable nature of mindfulness as a contributor to wellness.
Finally, a growing body of scholarly literature supports the feasibility of mindfulness practices for medical use. Most prominently, it is widely used in the field of lifestyle medicine, which focuses on the promotion of health and wellness. Stress reduction is among the most evident objectives of lifestyle medicine, which makes mindfulness and related practices applicable for use in the field. A meta-analysis by Victorson et al. (2014) suggested the presence of short-term benefits of mindfulness-based interventions, with the most common improvements in areas of weight management, dieting, and symptom burden relief.
Despite the narrow focus of the study, these findings allow assuming further use of MBI for a wider range of applications. Importantly, the study also detected the possibility of adjustment of the intervention’s duration without a significant decline in its effectiveness (Victorson et al., 2014). These results are relatively consistent throughout the field and were confirmed with the help of the Fie Facet Mindfulness Questionnaire (FFMQ) (Heeren et al., 2015). According to the findings of Heeren et al. (2015), mindfulness training is associated with both the reported increase in mindfulness skills and the decrease in psychological distress.
Overall, the reported results identify similar areas of improvement and include stress management, psychological resilience, greater satisfaction, and a range of related positive effects such as an increase in performance and engagement. All of the outcomes are consistent with the concept of wellness, which suggests the relation of mindfulness to the latter and its feasibility as an intervention technique.
Application to Recovery Practices
Following the recognition of mindfulness as a useful component of clinical practice, several interventions were either based on mindfulness training or complemented by it as a secondary technique.
Mindfulness-Based Stress Reduction
One of the most recognized types of interventions is mindfulness-based stress reduction (MBSR), intended for use with patients who have mood disorders or health conditions that produce chronic pains. The intervention is in the form of regular training sessions and usually lasts for eight weeks (Kabat-Zinn, 2013). Mindfulness training is a central activity during the sessions and is accompanied by group discussions, coping, and individual assignments. The training is based on the physical iteration of Eastern tradition and features Hatha yoga techniques, body scan technique, and breathing exercises throughout the course (Kabat-Zinn, 2013). The ultimate goal of the practice is achieving the non-judgmental and disconnected state in which the occurring thoughts are observed externally instead of being engaged.
Mindfulness-Based Cognitive Therapy
According to the information-processing theory of depressive relapse, the individuals suffering from recurring depressive episodes are vulnerable to reactivation of negative experiences through an encounter with the events triggering the undesirable memories (Baer, 2003). By extension, it is possible to negate or minimize the influence of a depressive episode by detaching one’s experience from the thoughts. The techniques include approaching recurring memories and thoughts in a non-judgmental way and perceive them as fleeting, temporary, and not necessarily accurate regarding reality. Such an approach is used to address depression, anxiety, and psychosis and is expected to prevent the cumulative effect of the negative experience. The MBCT intervention is constructed based on the MBSR model and utilizes the same eight-week timeframe.
Acceptance and Commitment Therapy
Acceptance and behavior therapy (ACT), used for treating a variety of mental disorders, does not directly refer to its techniques like mindfulness training and is not modeled after MBSR. Nevertheless, it is possible to consider it a mindfulness-promoting intervention since it demonstrates qualities consistent with the latter. For instance, the individuals undergoing ACT engage in self-reflective practices that discourage attachment to personal thoughts and feelings and suggest an impartial and analytical approach to personal feelings and sensations (Baer, 2003). The perceived nature of the experience is emphasized both verbally and cognitively during the sessions and is approached in a non-judgmental way, with impartial observation being a primary tool.
Dialectical Behavior Therapy
The central premise of dialectical behavior therapy (DBT) is the formation of the current reality from the interaction of opposing forces pertinent to the fundamental existence (Baer, 2003). The product of their interaction is the observed reality with its unique set of new opposing forces. Based on this, the patients are expected to accept their current state or condition and strive for improvement through changing the surrounding environment. The acceptance is achieved through observation, description, and non-judgmental evaluation. Despite the presence of a proactive element (change-facilitation), DBT incorporates mindfulness training and attains distress resilience and emotional stability on the same level. Importantly, DBT is somewhat less formal than MBSR in that it does not have strict requirements for meditation practices and offers a much broader range of options (Baer, 2003). Cultivation of mindful awareness is extended to routine tasks and is encouraged in everyday situations.
Relapse Prevention
Designed for prevention of relapse among individuals treated for substance abuse, relapse prevention incorporates mindfulness training for providing the patients with effective techniques of urge resistance. According to the theoretical basis of the intervention, substance abuse is caused by the inability to accept the changing nature of reality and aims at striving for the new bright experience by resorting to substance abuse. Mindfulness, on the other hand, allows accepting the recurring nature of changes and, by extension, the re-emergence of urges. The incorporation of mindfulness prepares the patient for the oncoming challenges, provides the means for impartial observation and non-engagement, and, therefore, allows for greater resilience and stability.
Distress Management
Mindfulness practices are also utilized for patients with health conditions associated with low quality of life and psychological distress. A pilot study by Stafford et al. (2015) provided evidence of the effectiveness of mindfulness-based interventions among women with breast or gynecologic cancer. Specifically, a direct relation was observed between the proficiency in mindfulness skills and quality of life and distress scores, with medium to large effect across the sample. Compared to the alternative options used for similar purposes, mindfulness-based interventions are less resource-heavy are incorporated more easily, and create favorable long-term effects.
The intervention is also desirable in the case when stress and anxiety associated with the condition pose additional risks. For instance, prostate cancer is among the most over-diagnosed conditions, with an estimated rate of 50% (Victorson et al., 2016). Also, many of the diagnosed individuals opt-in for treatment regardless of the severity of their condition, which, contributing to equally large overtreatment rates, while those who opt-out in favor of active surveillance live under constant stress. MBSR was shown to be effective in supporting the latter, more desirable options (Victorson et al., 2016).
Personal and Professional Use
In addition to direct applications in the clinical setting, mindfulness can be used to enhance critical thinking, guide self-management, and serve as a relaxation technique to decrease stress. For instance, it is reasonable to expect that incorporating meditation techniques will help me in situations where I need to interact with people who demonstrate a lack of tolerance to those not sharing their viewpoint. Also, it will allow me to make sound decisions and utilize existing information more effectively. Finally, I expect the emotional climate in my family to improve thanks to this approach.
I also expect to observe improvements in professional practice. First, the risk of inappropriate or unfounded decisions in the workplace will decrease. Second, my interaction with co-workers will become less stressful. Most importantly, I will be able to correctly identify emerging issues of both functional and managerial character and come up with effective preventive measures and mitigating solutions.
Conclusion
Since its introduction, mindfulness has found numerous applications both in a personal and professional setting. Despite initially conceived as a philosophical concept, it was successfully incorporated in health and wellness interventions and conclusively demonstrated as yielding positive results in addressing numerous mental health disorders. Its non-intrusive nature, holistic approach, self-sustaining quality, and an overall improvement in the quality of patient’s life place it among the most feasible options for achieving overall mental health and wellness.
References
Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125-143.
Broderick, P. C., & Frank, J. L. (2014). Learning to BREATHE: An intervention to foster mindfulness in adolescence. New Directions for Youth Development, 2014(142), 31-44.
Danilewitz, M., Bradwejn, J., & Koszycki, D. (2016). A pilot feasibility study of a peer-led mindfulness program for medical students. Canadian Medical Education Journal, 7(1), 31-37.
Erogul, M., Singer, G., McIntyre, T., & Stefanov, D. G. (2014). Abridged mindfulness intervention to support wellness in first-year medical students. Teaching and Learning in Medicine, 26(4), 350-356.
Heeren, A., Deplus, S., Peschard, V., Nef, F., Kotsou, I., Dierickx, C.,… Philippot, P. (2015). Does change in self-reported mindfulness mediate the clinical benefits of mindfulness training? A controlled study using the French translation of the Five Facet Mindfulness Questionnaire. Mindfulness, 6(3), 553-559.
Hudziak, J. J. (2016). Exercise, music, mindfulness, and parent training: Child and adolescent psychiatry prescriptions for health promotion. Journal of the American Academy of Child & Adolescent Psychiatry, 55(10), S276.
Ie, A., Ngnoumen, C. T., & Langer, E. J. (Eds.). (2014). The Wiley Blackwell handbook of mindfulness. New York, NY: John Wiley & Sons.
Johnstone, J. M., Roake, C., Sheikh, I., Mole, A., Nigg, J. T., & Oken, B. (2016). School-based mindfulness intervention for stress reduction in adolescents: Design and methodology of an open-label, parallel group, randomized controlled trial. Contemporary Clinical Trials Communications, 4, 99-104.
Kabat-Zinn, J. (2013). Full catastrophe living, revised edition: how to cope with stress, pain and illness using mindfulness meditation. London, England: Hachette UK.
Klatt, M., Norre, C., Reader, B., Yodice, L., & White, S. (2016). Mindfulness in Motion: A mindfulness-based intervention to reduce stress and enhance quality of sleep in Scandinavian employees. Mindfulness, 35(8), 1-8.
Stafford, L., Thomas, N., Foley, E., Judd, F., Gibson, P., Komiti, A.,… Kiropoulos, L. (2015). Comparison of the acceptability and benefits of two mindfulness-based interventions in women with breast or gynecologic cancer: A pilot study. Supportive Care in Cancer, 23(4), 1063-1071.
Tobin, K., Powietrzynska, M., & Alexakos, K. (2015). Mindfulness and wellness: Central components of a science of learning. Innovación Educativa, 15(67), 61-87.
Victorson, D., Hankin, V., Burns, J., Weiland, R., Maletich, C., Sufrin, N.,… Brendler, C. (2016). Feasibility, acceptability and preliminary psychological benefits of mindfulness meditation training in a sample of men diagnosed with prostate cancer on active surveillance: Results from a randomized controlled pilot trial. Psycho‐Oncology, 13(5), 1-9.
Victorson, D., Kentor, M., Maletich, C., Lawton, R. C., Kaufman, V. H., Borrero, M.,… Berkowitz, C. (2014). A systematic review and meta-analysis of mindfulness-based randomized controlled trials relevant to lifestyle medicine. American Journal of Lifestyle Medicine, 9(3), 1-27.
Wisner, B. L. (2014). An exploratory study of mindfulness meditation for alternative school students: perceived benefits for improving school climate and student functioning. Mindfulness, 5(6), 626-638.