What Is Mindfulness?
Part 1 of 3
Mindfulness means maintaining a moment-by-moment awareness of our thoughts, feelings, bodily sensations, and surrounding environment.
Mindfulness also involves acceptance, meaning that we pay attention to our thoughts and feelings without judging them—without believing, for instance, that there’s a “right” or “wrong” way to think or feel in a given moment. When we practice mindfulness, our thoughts tune into what we’re sensing in the present moment rather than reliving the past or imagining the future.
Though it has its roots in Buddhist meditation, a secular practice of mindfulness is in the American mainstream in recent years, in part through the work of Jon Kabat-Zinn and his Mindfulness-Based Stress Reduction (MBSR) program, which he launched at the University of Massachusetts Medical School in 1979. Since that time, thousands of studies have documented the physical and mental health benefits of mindfulness in general and MBSR in particular, inspiring countless programs to adapt the MBSR model for schools, prisons, hospitals, veterans centers, and many more.
What We Still Don’t Know about Mindfulness Meditation
During the past three decades, a lot has been discovered about mindfulness—and specifically meditation, which is one of the best ways to cultivate moment-to-moment awareness of ourselves and our environment.
Research has suggested that in a few short weeks, mindfulness meditation practice can bring about physiological, psychological, and social benefits in our lives. From increases in gray matter in the brain to alleviating physical ailments such as migraines and fibromyalgia, the benefits of mindfulness and meditation practice more generally have been touted for everyone ranging from executives to schoolchildren.
While some have been critical of the science behind mindfulness meditation due to poor study designs and small effect sizes, this hasn’t curbed mainstream interest. A recently published study sought to examine the print media coverage of meditation between 1979 and 2014 and discovered that there’s a near inescapable global amount of positive coverage of meditation.
With so many positive claims about mindfulness meditation, it can be difficult to decipher which claims have the most research behind them and which are still preliminary or speculative. In fact, there is a great deal we don’t yet understand about mindfulness and meditation.
What are the actual benefits of mindfulness meditation?
Just recently, I’ve seen headlines promoting how mindfulness and meditation practices may “decrease your risk of cancer,” “reduce holiday excess,” and help athletes rise to the top. Are these claims true?
A recent analysis published in JAMA Internal Medicine caused a bit of a stir in the meditation community. This analysis examined 47 randomized controlled trials of mindfulness meditation programs, which included a total of 3,515 participants. They found that meditation programs resulted only in small to moderate reductions in anxiety, depression, and pain. The authors note that although these effects are small, they are “comparable with what would be expected from the use of an antidepressant in a primary care population but without the associated toxicities.”
Surprisingly, this review showed low evidence of improvements in quality of life. Furthermore, there was also low, insufficient, or no evidence of meditation programs’ effect on positive mood and feelings. According to the authors, meditation programs were not shown to be more beneficial than active treatments—such as exercise, therapy, or taking prescription drugs—on any outcomes of interest. But, Meditation did not seem to be harmful.
While it’s possible that the benefits of mindfulness practice and meditation generally may be more modest than originally assumed, several important barriers to the study of contemplative practices influence the quality of research being conducted. Most notable are the lack of funding (which influences number of participants, study length, and design) and poor measurement tools (which have been limited primarily to questionnaires of varying quality, an issue also likely tied to the lack of funding). While private and federal research grants are indeed awarded to the study of contemplative practices, these grants are typically much smaller than those awarded to more traditional research (e.g., cognitive behavioral therapy or pharmacology trials).
Nevertheless, the consensus from this analysis is that while there are some benefits, mindfulness meditation programs are not a cure-all to every modern-day ailment.
How much practice is enough?
“How much meditation practice is enough?” Most people are looking for a CDC type of response(e.g., 3 times a week for 45-60 minutes), There is an old Zen saying: “You should sit in meditation for twenty minutes every day—unless you’re too busy. Then you should sit for an hour.” To date, researchers have yet to arrive at a consensus about how much is “enough.”
Many meditation programs suggest that participants practice formal meditation (the “on the cushion” practice) anywhere from 15-30 minutes per day, 5-7 days per week. Many research studies, including some published research at Stanford University on Mindfulness-Based Stress Reduction and Compassion Cultivation Training, have found that some (not all) of the benefits from these programs are “dose dependent”—meaning that the participants who report the greatest amount of meditation practice are the ones who show the greatest gains. This is not universally true; there are some outcomes that do not seem to be influenced by minutes of practice. As is often the case, the research is mixed.
Aside from the raw number of minutes, other factors may interact to influence the benefits of mindfulness practice: the type (e.g., formal sitting meditation practice vs. informal meditation practices, mindfulness vs. compassion, etc.), the frequency (e.g., multiple times a day, multiple times a week), and the quality (e.g., sitting and actually doing the practice vs. doing the practice “on the go”). Using the analogy of going to the gym: It’s not enough to simply think about going to the gym, or talk about going to the gym, or wear gym clothes around town, or only go to the gym for a few weeks after making New Year’s resolutions. In order to gain the most benefits out of going to the gym, one has to really show up and do the exercises on a regular basis.
While it’s possible that in the next 10-15 years we will see a CDC-style recommendation regarding meditation practice, to date, the empirical data on the topic are still inconclusive. So my recommendations (for the time being) are to try out different durations, types, and frequencies of meditation and jot down how you feel before and after the practice. It’s even important to experiment with different times of the day. Making time to intentionally reflect on your experiences with the practice is key. The only way to find out what’s right for you is to experiment.
Is there a dark side to meditation?
One of the big misconceptions about mindfulness practice and meditation more generally is that they will induce a sense of peace, calm, and stress reduction. While this can be the experience for some, it is not the experience for all. At times, sitting quietly with oneself can be a difficult—even painful—experience. For individuals who have experienced some sort of trauma, sitting and meditating can at times bring up recent or sometimes decades-old painful memories and experiences that they may not be prepared to confront.At times, it may be appropriate to seek outside support when practicing meditation, such as short-term psychotherapy, support groups, or meditation sangha groups. It’s also possible that some practices are more “difficult” than others. For example, practices where you visualize yourself as a small child might be particularly difficult if you experienced some sort of abuse as a young child. Rather than powering through the practices, be willing to gauge whether a particular type of meditation is suitable for you at this time in your life.
Mindfulness..... What, Why, How Part 2 of 3