Friday, November 6, 2015

THE FUTURE OF MINDFULNESS AS MEDICINE

A recent article in the Journal of the American Medical Association looks at the potential of mindfulness as a medicine in its own right.

The article notes the role of Dr Jon Kabat-Zinn [pictured left] in establishing a course in mindfulness-based stress-reduction (MBSR) and the work of cognitive psychologist Zindel Segal, who developed a program in mindfulness-based cognitive therapy (MBCT), a blend of mindfulness-based stress reduction (MBSR) and cognitive behavioural therapy (CBT).

The JAMA article also notes that Dr Herbert Benson [pictured below right], founder of the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital, and author of the landmark 1975 bestseller The Relaxation Response and other books such as Beyond the Relaxation Response, is often credited as bringing mindfulness into the realm of Western medicine. Many of the exercises and techniques contained in The Relaxation Response are very similar to, if not actually indistinguishable from, the practice of mindfulness. I well remember when that book came out, and what an incredible impact it had at the time and for many years thereafter.

So, mindfulness has respectable roots. However, the JAMA article quotes one proponent of mind-body medicine who sees some resistance to mindfulness among members of the medical profession. ‘Many physicians who consider themselves grounded in Western science will see mindfulness-based programs for mental health disorders as being faddish,’ says Dr Gregory L Fricchione. Be that as it may, the article notes that some 79 per cent of medical schools now offer some element of mindfulness training.

Since 1967 over 1,500 studies worldwide have been conducted by over 250 independent research institutes and centres showing mindfulness meditation to be clinically effective for the management of, among other things, stress, depression, anxiety and panic disorders, chronic pain, substance abuse, eating disorders, obsessional thinking, impulsivity, strong emotional reactivity and a wide array of other medical and mental health related conditions. 

There is also documented evidence that mindfulness results in improvements in learning and consciousness, enhanced cognitive functioning and performance, and improvements in concentration, attention to detail and ability to cope with stress. In addition, mindfulness fosters ethical behaviour and empathy, improves skills in leadership, problem-solving, negotiation and mediation, and enhances self-esteem and self-awareness.

Despite all of the foregoing, old prejudices die hard. ‘All professions are conspiracies against the laity’, wrote the Anglo-Irish playwright George Bernard Shaw. The medical and legal professions, in Shaw’s view, would be at the top of the list, along with banks and insurance companies. So, it may well be the case that, insofar as the practice of Western medicine is concerned, mindfulness will remain as one of many forms of complementary medicine. However, mindfulness as meditative intentional awareness is indeed medicine and exercise for the mind as well as for the body. The etymological meaning of the modern English word ‘meditation’ is most interesting to say the least. The word is derived from the Latin word meditatus, past participle of meditari, frequentative of medēri, which is related to, among other things, the English word ‘middle’. As we all know, the middle position avoids and transcends the extremes at both ends, and thus all opposites. The word ‘meditation’ is also etymologically related to such other English words as ‘mediation’, ‘medical’ and ‘measure’ and also denotes the activities of ‘reflecting’ and ‘pondering’ --- not reflecting or pondering in any analytical sense but in the sense of directly perceiving what is.

Dr Robert Ellwood [pictured left], who was a professor of world religions at the University of Southern California from 1967 until his retirement in 1997, wrote a most useful little book on the subject of meditation entitled Finding the Quiet Mind (TPH, 1983). In that book Ellwood, after referring to the etymological origins of the word, defines, or rather describes, meditation as ‘medicine for the mind which does its work by measuring out time, when it can reach a median, a point of equilibrium’. I like that.

Mindfulness has been called a fad but it is much, much more than that. No other form of meditative awareness has been as well-researched. Its health benefits are well-documented. It will not disappear.

Onward and upward.


Resource: Buchholz, L. ‘Exploring the Promise of Mindfulness as Medicine.’ JAMA. 2015;314(13):1327-1329. October 6, 2015. doi:10.1001/jama.2015.7023. 



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