Mindfulness Approach - Essay Example

The ethical, theoretical, research and practice based aspects of mindfulness in relation to One Mindfulness Approach Introduction Mindfulness isan aspect that is closely related to the present state of consciousness. From ancient times this concept of mindfulness has been identified by many religions and philosophy, and is have known to have nurtured and nourished human health and well being, in both physical and mental contexts of an individual. As Wilber tells us, that many spiritual, philosophical and psychological cultures accentuated the significance of consciousness for the sustenance and augmentation of the well being of their people (Wilber, 2000). Now the basic question that arises in our minds is that, is there really a connection between being consciously present and remaining healthy? To understand this we will have to explore the term mindfulness and its connection with the concept of well being. Mindfulness is a concept that is closely related to Buddhism and Hinduism, and other similar traditions where conscious awareness is propagated. Mindfulness can be defined as “the clear and single-minded awareness of what actually happens to us and in us at the successive moments of perception” (Nyanaponika Thera, 1972, p.5). It has also been defined as “keeping one’s consciousness alive to the present reality” (Hanh, 1976, 11). Recent researches in this line have reached the conclusion that if mindfulness is enhanced by proper guidance and training, it brings in positive results. Various negative attributes in a human mind like that of stress, anxiety, depression, mental disorders, and health related problems like cancer are alleviated to some extent, when treated with the mindfulness theory, that apply yoga and Buddhist traditional approaches used for the alleviation of distress. In this process the patient can be guided to follow the practices of mindfulness with various applicable approaches, from the perspectives of psychoanalytic and cognitive-behavioural aspects. This article will explore the validity of claims that applying the theories of mindfulness can lead to betterment of mind and body. It will study all the concepts associated with the ethical, theoretical, research and practice based aspects in context with the well being approach of mindfulness. It will also evaluate the effectiveness of this intervention on various health disorders like anxiety, cancer, and depression and will establish the effectiveness of this procedure when applied for psychological well being. Body The concept of mindfulness: Mindfulness can be explained in various ways. The most basic way to rationalise this concept is to seek its connection with the consciousness of a human mind. In this context, mindfulness can be seen to be the conscious awareness that has no bias, no prejudice, is not judgemental, and does not delve to delete or summate anything from the present experience. As Brantley tells us “mindfulness arises when one pays attention on purpose in an allowing, accepting way to inner and outer experience unfolding in the present moment. Mindfulness is not limited to rigid or formulaic methods of meditation, but is available to be experienced in each moment and with every breath” (Brantley, in Orsillo and Roemer, 132, 2005). Kabat-Zinn in their article defines mindfulness as “commitment to reside as best one can from moment to moment in awareness with an open heart, a spacious, non-judging, non-reactive mind, and without trying to get anywhere”( Kabat-Zinn, 237, 1994). The concept of awareness of the present moment is important amongst many ancient faith healing concepts, like as we see in yoga. Buddhism also has developed methods where meditation lays great emphasis on mindfulness. In fact Mindfulness Based Stress Reduction (MBSD) was a program first started in 1979, in the Medical Centre at the University of Massachusetts, based on the very principles of Buddhism that teaches mindfulness through meditation. This program was mainly designed to train people in the art of mindfulness yoga and meditation to alleviate stress, illness, and pain, and to improve the overall health of an individual. To understand the connection between mindfulness and Buddhism, we will have to explore what the Buddhists as a tradition have been following for the last 2500 years, while practicing mindfulness through their various meditative practices. Buddhism and the concept of mindfulness: A close look at the chief tenets of Buddhism will show that Lord Buddha in his sermons had asked his followers to pursue the process of meditation to achieve the ultimate state of enlightenment or nirvana. As per His instructions, one should find a place that is comfortable, and before sitting down to meditate one should be in a calm frame of mind and abolish all disturbing thoughts that cause mental stress. In this state of mental tranquillity an individual will be transported to “a state beyond any considerations of well being and suffering…in transcendent moments like these the mediator will know how valid are the Four Noble Truths…the lay person will return to worldly concerns, of course, but these moments of tranquility and illumination will enable him or her to evaluate them differently…through the deeper experiences of meditation, each practitioner can find that he or she is experiencing eternity now, and this knowledge can transform the rest of their activities. This may not be religion as biblical and ecclesiastical theists describe it, but one cannot contemplate describing this as anything other than a religious experience: and it is religion without god” (Billington, 71, 2002). The chief aim of Buddhism lies in the realisation of these Four Noble Truths. These are “There is unsatisfactoriness, discontent, anguish or suffering. Discontent has origins or root causes There is freedom from anguish There are pathways to freedom” (Einstein, 46). In medical models these very truths can be easily represented in terms of i) Disease or disorder, ii) The aetiology of the disease, iii) Hope for regaining health and iv) the treatment necessary to regain health. The Buddhist First Truth is known as ‘Dukkha’ or unhappiness/suffering, and in the modern day medical version refers to all the emotional stress arising due to certain psychological disorder related conditions. The Second Truth which refers to the causes of this Dukkha or suffering, defines the basic factors that create this suffering and are mainly related to various mental and behavioural conditions like a strong craving or clinging towards something material, reluctance to accept something that is unpleasant and unwanted , and being psychologically unconscious about one’s present condition. The hope for Nirvana is the Third Truth that Buddha talked about, and means freeing oneself from the ties or factors that causes suffering. It actually means that a person should force himself to get out from a state of blind panic and comprehend the situation with an open mind. Once an individual gets out of the panic cycle where he is reluctant to accept the reality, then he can move on to the state of acceptance, where he will also be able to discard all the ‘misinterpretations’ predicting catastrophic results, and thus will be freed from the factors that cause suffering. As Thera tells us “insight from mindlessness is helpful in discovering false conceptions due to misdirected associative thinking or misapplied analogies (Nyanaponika Thera, 1972, p. 52). To achieve complete freedom from all suffering one should follow the path of mindfulness meditation and achieve the state of tranquillity. Buddha also outlined the eightfold path that helps in understanding the Four Nobel Truths, which is the road to ‘Dharma’. The eightfold path can be divided into three main types. These are wisdom, ethics and meditation. The wisdom consists of a full comprehension and skilful choice. Ethics comprises of skilful action and expression, and the correct occupation. Meditation refers to the right state of mindfulness and focus, and a balanced state of energy within an individual, that ultimately leads to the healing process. As Hanh tells us that, “Meditation, another word for mindfulness, is not evasion; it is a serene encounter with reality” (Hanh, 1976, p. 60). What is the nature of mindfulness? It can be framed as “The term ‘mindfulness’ refers to keeping one’s consciousness alive to the present reality” (Hanh, 1976, p.11). Consciousness is an attribute of a human mind that can be easily disjointed from all other attributes like cognition, emotions or motives, which relate to the innate nature of that particular individual. “Thus, one can be conscious of thoughts, motives, and emotions as well as sensory and perceptual stimuli. Consciousness encompasses both awareness and attention” (Brown and Ryan, 2003, 822). Awareness can be actually be likened to the antennae at the back of consciousness, which continually scans the surrounding environment, while attention is like focussing all concentration on a particular experience. So “Mindfulness can be considered an enhanced attention to and awareness of current experience or present reality” (Brown and Ryan, 2003, 822). As for example when communicating with a close relative or friend, an individual will pay full attention to the ongoing communication and at the same time is aware of all the underlying emotions that are present. While performing multiple tasks at the same time, the attention and awareness of an individual may vary. There may also be instances where the mindfulness of a person may be compromised, especially when he is doing some mundane routine work that arouses no interest in him, or when he is forced to do something that seems a burden or a chore to him. Lying diametrically opposite to the concept of mindfulness is the term ‘mindlessness’ where an individual refuses to acknowledge a certain situation or emotion. Thus “Mindfulness captures a quality of consciousness that is characterized by clarity and vividness of current experience and functioning and thus stands in contrast to the mindless, less “awake” states of habitual or automatic functioning that may be chronic for many individuals”( (Brown and Ryan, 2003, 823). Relation between the well being of an individual and mindfulness: During the last two decades it has been noticed that there has been growing support for mindfulness, amongst psychotherapists using various cognitive and behavioural therapies to treat their patients. There are various programs where mindfulness from the core approaches to the various treatments. These are mindfulness-based stress reduction (MBSR), acceptance and commitment therapy (ACT), mindfulness-based cognitive therapy (MBCT) and dialectical behaviour therapy (DBT). With the exception of ACT, all other therapies base their approaches on the Buddhist concept of mindfulness. Ethical aspect of using mindfulness: There has been much speculation by various researchers like Brown and Ryan (2004), Bishop et al (2004), as to whether the religious traditions of yoga mindfulness, and the Buddhist approach of mindfulness through meditation, should be allowed to pervade the realms of the psychological and scientific world. Doubts have also been expressed as to whether it would be ethical as per the medical norms to actually allow ancient religious healing traditions to amalgamate with modern clinical methods. However, most of the modern day psychotherapists are willing to accept these ancient religious healing techniques and also give them their due credit. As Baer (2003) tells us that, mindfulness is slowly gaining credulity as an effective scientific method to treat various psychological disorders. Another reason as to why mindfulness has gained prevalence amongst the western psychotherapists and is being given a medical ethical certificate, is because the Buddhist approach to this process is in accordance to modern constructivist ideas, and also the teachers of this religion have specifically pointed out that one need not convert to Buddhism to follow the path of mindfulness (Safran, 2003, 21-22). Clinical or practice aspect of mindfulness: An important aspect of mindfulness that is popular amongst clinicians is as pointed out by Thera, “mindfulness enters deeply into its object...and therefore ‘non-superficiality’ will be an appropriate... term, and a befitting characterization of mindfulness” (Nyanaponika Thera, 1972, p.43). This is approved by various psychotherapists as they feel that their clients owing to their condition of mental disorders often keep on reiterating their sagas on the conscious level. By using mindfulness therapy these patients can be made to feel superficial and thus would avoid repeating their stories on the conscious level. On clinical grounds during treatment the psychotherapist treats the conscious mindfulness separately from the ordinary everyday conscious levels (Johanson & Kurtz, 1991). Here the awareness is turned inwards, where one examines various experiences with the eyes of a third person. He is mentally inert, though completely dehiscent to curiosity, exploration and is fully cognizant of the present situation around him, though the person does not make any move to assert or confirm anything. So here the psychotherapist using the theories of mindfulness helps his patient to consciously suspend all judgements of any kind, discard all sort of mental agendas, and remove all ordinary common place understanding. This situation can be comparable only to that of a child who is playing, putting his entire concentration to the game in front of him. Ordinary every day consciousness on the other hand, continuously tries to turn the awareness to attributes that are externally located, the attention also being outwardly directed. However one very important thing has to be kept in mind here. Mindfulness does not refer to the so called hypnotic trances, where one suppresses the conscious awareness of a person. Instead, in mindfulness, the level of awareness is increased, and as Wolinsky opines, it is actually an opening where one can escape from the trances that we face daily, owing to our habitual and machine like conditioning and our unconscious state of everyday existence (Wolinsky, 1991). Psychotherapists belonging to the School of Experience: Various therapists have long used mindfulness in treating patients without being aware of its existence in ancient traditions, and without making any direct references to this process. Gendlin in 1978, developed a method which he termed as focusing. Here he has mentioned the use of the ‘sense of feeling something’, and had turned it to effectively help his patients. Gestalt psychotherapists like Rosenblatt in 1975, asked his patients to focus on the present moment, while Schwartz (1995) directed his patients to turn their sense of awareness inwards and also suspend all forms of judgement. Even Freud in his ‘free association theory’ advocated crossing the threshold of everyday consciousness. So as a whole, it as Germer suggests, “The word mindfulness can be used to describe a theoretical construct (mindfulness), a practice of cultivating mindfulness (such as meditation), or a psychological process (being mindful)” (Germer, 2005, p. 6).  It is the awareness of each moment that counts in the process of healing. The humanistic school of thought: Ron Kurtz in the 70s was the first psychotherapist who synthesized the teachings of Hahn and Nyanaponika with that of practical psychotherapy treatments, and invented the Hakomi therapy which was based on the Buddhist theories of mindfulness. One very pragmatic concept of mindfulness is that it teaches a patient to restrain himself. “In practicing bare attention, we keep still at the mental and spatial place of observation, amidst the loud demands of the inner and outer world.  There is strength of tranquility, the capacity of deferring action and applying the brake, of stopping rash interference, of suspending judgment while pausing for observation of facts and wise reflection on them.  There is also a wholesome slowing down in the impetuosity of thought, speech and action” (Nyanaponika, 1972, p.25). This showcases the restraining power of mindfulness which can be transpired to the patients, and this very power was used by Kurtz during therapies, where he advised and guided people to slow down and reflect over certain experiences internally, and then inviting them to speak out about these feelings in retrospection. As Nyanaponika had advised, “use your own state of mind as meditation’s subject.  Such meditation reveals and heals...The sadness (or whatever has caused the pain) can be used as a means of liberation from torment and suffering, like using a thorn to remove a thorn” (Nyanaponika, 1972, 61). Wilber (2000) and Schanzer (1990) also propagated the mindfulness through meditation, as they both claimed it helped an individual to undergo many personal changes which were of the positive nature and also raised the general level of awareness. As Bobrow, further add to the benefits of mindfulness through meditation “meditation cultivates the capacity to hear when we listen, see when we look, and taste when we eat” (Bobrow, 2003, p. 399). The psychodynamic school of thought propagated the exploration of the depths of the mind, which would aim to integrate the fractured minds, which are often seen in cases of psychological disorders. In fact, this should be the first aim of the psychotherapists, as per this school of thought, before any transition from the state of clinging or attachment, is made towards the higher state of detachment. As Engler would let us know, that it is “developmentally necessary to acquire a cohesive and integrated self first that is differentiated from others and has a degree of autonomy” (Engler, 1998, p.51). So, one need to do a thorough inward study of his own inner self, before he can be allowed to proceed towards attaining higher perspectives. Epstein in his article in 1996 had discussed in length the connection between psychotherapy and Buddhist traditions. Surrey (2005) has created a Relational-Cultural Theory (RCT) where the “mindfulness practice supports the capacity of the therapist to attend to connection, and in the process, repair breaches” (Surrey, 2005, p. 93) and this process can be “can be understood as a potent form of ‘co-meditation,’ harnessed as a method to further mindfulness” (Surrey, 2005, 94). Thus, in this process of the healing of the mind through application of mindfulness, enables the patients to find out and speak out about their own truths and by following the Buddhist process of giving them time and space, allows the patient to slowly come out of his shell. Mindfulness and the cognitive behavioural therapy: The recent trend shows that the concepts of mindfulness are also being used widely to treat patients under various clinical therapies. In fact as Hayes, Follette, and Linehan would let us know “In the last 10 years, a set of new behavior therapies has emerged that emphasizes issues that were traditionally less emphasized or even off limits for behavioral and cognitive therapists, including mindfulness acceptance, the therapeutic relationship, values, spirituality, meditation, focusing on the present moment, emotional deepening, and similar topics” (Hayes, Follette, and Linehan, 2004, p. xiii). Kabat-zinn’s work on MBSR (Mindfulnesss Based Stress Seduction program) has shown positive results with patients suffering from chronic pain and other debilitating conditions. Segal, Williams, and Teasdale while working on a program for patients suffering from depression, found that using the de-centering part of cognitive therapy would be best suited for this plan. Realising that this was an essential part of the Buddhist theory of mindfulness, they closely studied MBSR, and came up with something based on similar lines known as MBCT (mindfulness based cognitive therapy), applied on the patients with depression and got immediate positive results. Even the Act therapy which does not directly base it theory on Buddhist mindfulness, does indeed reflect certain parts of the same mindfulness ideology when it speaks of cognitive diffusion, acceptance, and self, and valuing one’s life. Research findings of mindfulness mediation in various disorders: Buddhism believes that mind is the root of all human happiness and misery. Mind is also the fundamental viewing object through which one sees the natural world around, and develops his own perspectives. The Buddhist teachers, over the years, have developed to almost perfection the ways of training the conscious mind, and methods to control excitement and laxity to create a calm mind, which can detach itself from the surrounding chaos. It is this ancient system of mind control that the modern day psychotherapists are integrating into their clinical therapies, and on applying it on their patients, are getting wondrous results. Stress and anxiety: Tests were conducted by Flinton in 1998, on 42 juvenile delinquents who were made to perform mindfulness meditation, progressive relaxation, and were taught various concentration techniques, for a period of 8 weeks. After the program was over it was noticed that anxiety levels were down considerably and the concentration focus in the participants also seen to be directed inwards. Greene and Hiebert in 1988 experimented on a group of 24 college-going students, and conducted a three session program that included meditation or cognitive self observation. After the program it was noticed that there was an increase in the levels of self actualisation, and a significant decrease in symptoms related to stress. Fibromyalgia: Tests were conducted by Kaplan, Goldenberg, & Galvin-Nadeau, 1993 on 77 patients with fibromyalgia, who were made to undergo mindfulness based stress reduction program through meditation, for a 10 week course, and after which it was reported that the patients felt less pain and fatigue, enjoyed more hours of sleep and were more refreshed when they woke up in the morning and were also coping with the disease better. Smoking: Arcari, 1997 performed experiments on smokers and conducted a program where the participants were made to undergo a mindfulness meditative course. Results showed significant decrease in the smoking habit, with lower stress and depression amongst the participants.  Cancer: Mindfulness based meditation programs when applied on cancer patients by Speca et al., 2000, have shown that it helped the sufferers cope with the disease better. It lowered the stress levels, produced better pulmonary and digestive results. With a better knowledge of their inner self, the patients also coped better with their situation, and were able to enjoy the remaining available days of their lives. Conclusion Meditation based mindfulness theories originating from the yoga (Hinduism) or Buddhism based meditation, when integrated with modern psychotherapeutic methods have shown to produce wondrous results. 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