1. Managing Stress through Mindfulness Meditation

2. What Is Mindfulness Meditation?  Distinction between ‘mindfulness’ and ‘mindfulness meditation (MM)’  Mindfulness is paying attention to the present moment  MM also includes a direct, experiential understanding/ insight into the nature of mental activity and mental events

3.  Although present in all spiritual traditions, MM as it is being taught in the West draws it’s inspiration and technique from Buddhism  MM was taught as a powerful, gradual method of self-knowledge and self-mastery through disciplined observation of mental processes

4.  MM includes two main components: tranquility meditation (TM) and insight meditation (IM)  TM: calming the mind, usually by maintaining awareness of the breathe and resisting focusing on the contents of mental activity  IM: understanding the ‘nature’ or main characteristics of mental events and mental activities and our relationship to them

5.  core skill defining mindfulness is the capacity to respond to mental events with an attitude of non-judgmental, accepting, present-moment, awareness (Segal, Williams & Teasdale, 2002)  “…dispassionate, non-evaluative, and sustained moment-to-moment awareness of perceptible mental states and processes” (Grossman et al., 2004)

6.  Mindfulness-based stress reduction (MBSR), usually delivered in 8 weekly sessions, has emerged as one of the better known clinical applications of MM ( Kabat-Zinn, 1990 )  MBSR has been shown to significantly benefit individuals with a diverse set of conditions when included as an adjunctive intervention, including :  chronic pain (Kabat-Zinn et al., 1987),  cancer (Speca et al., 2000),  anxiety disorders (Kabat-Zinn et al., 1992),

7.  eating disorders ( Kristeller & Hallett, 1999 )  fibromyalgia (Goldenberg et al., 1994)  relapse to depression (Segal et al., 2002).  Psoriasis (Kabat-Zinn et al., 1998)  Stress (Williams etal., 2001)  addictive behavior (Marlatt, 2002)

8. How Does Mindfulness Help?  Relaxation?  Desensitization?  Distraction?  Increased frustration tolerance?  Extinction?  Acceptance?  Insight into nature of mental activity?

9.  Spiritual teachings that form the basis for MBSR and other MM interventions stress all of these pathways but especially the last one: insight  Such insight reflects the experientially-based conviction that mental events are impermanent, lack any essential / objective existence, and can exacerbate suffering and distress  By comparison, lack of insight attributes a substantiality and power to mental activity that it, by nature, does not possess

10. “Pain is unavoidable; Suffering is optional”  MM addresses the suffering or distress associated with mental and physical illness by skilful training in this insight  most modern MM interventions include extensive practice in MM, breathing exercises, yoga/ body awareness, compassion training and other elements

11.  Although research to date is generally supportive, it is not yet definitive  Research is being directed towards measuring M, evaluating which components of MM are most effective, understanding the biology/ neuroscience of MM, and the mechanism by which it benefits

12. What Happens During MM?  Although evidence for the efficacy of MM is growing, very little is known about what is happening while people meditate  Without greater understanding of what is actually happening ‘within the mind’ it is very difficult to convincingly attribute any benefits of MM to actual MM  Our study was designed to obtain some evidence related to this question

13. Study of Mindfulness Process  Healthy sample of 17 undergraduate students  Received course credit for participating  Most had previous MM experience  Asked to meditate 20’ daily for 8 weeks  Recorded their subjective experiences of MM on a daily basis  Provided with weekly instruction by TT  Pre/post assessment of depression, anxiety, somatic stress, mindfulness skills

14.  Daily diary rated the frequency* of the following aspects of MM:  Feelings of tranquility and calm  Ability to remain present-focused  Ability to remain non-distractible  Distancing from mental activity  Nonjudgmental attitude towards mental events  Restlessness and agitation  Maintaining attention on the breathe * ranging from ‘none of the time’ to ‘all of the time’ on a 6-point scale

15. Weekly instruction encouraged:  attention on breath;  noting mental activity but neither ‘avoiding’ or ‘holding’ on to them;  permitting mental events to naturally arise and subside without interference  attitude of curious, benign observation similar to the experience of ‘watching clouds cross the sky’

16. Results  14 females; 3 males  Mean Age in early 20’s  Frequency of meditation: 79% of days or 44/56 (ranged from 50% to 100% compliance)  Length of daily meditation: 17 min/day or 1.6 hrs. per week (~13 hours in total)

17.  Lower anxiety scores post-8 weeks were significantly associated with higher ratings of the following towards mental activity:  nonjudgmental/accepting attitude (~r=. -75 )  non-distractibility (~r =-. 58)  present-focus (~r=-.60)  achieving tranquility (~r = -.50)

18.  Lower depression scores post-8 weeks was significantly associated with higher rating of:  nonjudgmental/accepting attitude (~r=.70)  Lower somatic symptom scores post-8 weeks was significantly associated with:  amount of time spent in MM (~r=.65)

19.  Significant improvements in ratings of behavioral impulsivity, social relationships and role effectiveness also found  Subjects with > 11 hrs of MM during the study had significantly higher ratings on measures of present-focus and non- distractibility than those with <11 hrs of MM

20.  The more time spent in MM per day ( which ranged from 9 - 40 minutes with an avg of 17 minutes ), the higher the rating for maintaining:  present-focus (r=.80),  non-distractibility (r =.78),  tranquility (r =.73) and  non-restlessness (r =.64) at the end of the 8-weeks

21. Summary and Conclusions  MM is increasingly being shown to be an effective adjunctive intervention for the alleviation of mental and physical illness- associated stress and suffering  While we know little about what occurs while people practice MM, this study showed that a brief, 8-week program with healthy undergraduates produced measurable benefits with only ~17 minutes of MM/ day

22.  Specifically, skill in maintaining present- focus, a non-judgmental attitude and tranquility was associated with lower frequency in negative moods such as anxiety and depression  reduced physical symptoms of stress was most associated with time spent in MM

23.  Since more time meditating was associated with stronger effects it is likely that practicing MM for about an hour/ day (which is commonly recommended) would yield correspondingly stronger effects, especially in populations who are in significant clinical distress  However, even in non-clinical populations, improvements were evident with as little as 17 min/day over a two-month period

24.  In conclusion, MM is an ancient but novel intervention that is showing potential to help reduce stress and suffering and to also increase self-understanding if practiced regularly and properly

25. MM Instructions  maintain erect but comfortable sitting posture  maintain attention on rhythym of breathing  when distracted by any mental activity, note/label distraction and return attention to breathing  do not force the mind neither to think or to not think  neither encourage thought nor block it  permit thoughts to arise, briefly abide, and subside  observe your mind dispassionately but alertly  if thoughts come, let them come; if they go, let them go; if they stay, let them stay