A drug-free mindfulness prescription (1)

“Mindfulness.” Most of us have heard of it. Some of us may have actually tried to practice it. But how many of us know exactly what it means?

This troublingly vague term can be applied to almost anything: mindful breathing, mindful cooking, mindful cleaning, mindful walking, mindful dishwashing, mindful coloring-in.

• Is it just another way of describing good old-fashioned relaxation?
• A fancy form of meditation?
• Or an offshoot of that other mental-health buzz term, cognitive behavioral therapy (mindfulness-based stress reduction)?

The truth is that modern mindfulness is a well-defined clinical treatment [in psychology] for a surprisingly wide range of conditions. It has been used by clinicians for five decades and, during that time, has accumulated a huge weight of evidence to support its efficacy.

From stress and anxiety to depression, psychosis, and pain management, mindfulness has helped millions of people across the world with an array of mental, and even some physical, illnesses.

Even if one is not actually sick, practicing mindfulness has the capacity to improve the quality of everyone’s day-to-day life.

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Founder of Taoism Laozi/Lao Tzu

Fundamentally, mindfulness is a mental practice that allows us to focus our attention on the present moment, helping to counteract excessive rumination and worrying (falling into the past or leaping into the future) to become more aware of our own thoughts and feelings, thereby enabling us to better control or accept them.

It is derived from the Buddhist term sati, and the Hindu Sanskrit term smrti (“memory”), meaning “to remember to observe.

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“It’s about becoming aware of the messages your body sends you,” says Angie Ward, chief experience officer and tutor at the teacher training organization MindfulnessUK.

“Often our body picks up on signals of emotional discomfort before our brain does. By learning to tune in to the body’s responses, we can make ourselves more aware of how we are feeling and try to respond to our feelings and the situation, rather than react to them in unhelpful ways. Noticing our thoughts can stop the mind from wandering into difficult places as we can choose to bring it back to the moment. It’s not about trying to feel Zen; it’s not about trying to feel anything. It’s just about noticing the way you already feel.”

Clinical use of mindfulness in the West is widely thought to have been started by Dr. Jon Kabat-Zinn, professor emeritus of medicine at the University of Massachusetts Medical School, who took ancient Buddhist applications surrounding meditation, yoga, and spirituality and applied them in a secular, scientific way.

Mindfulness pioneer Jon Kabat-Zinn drew on ancient Buddhist ideas surrounding meditation, yoga and spirituality - Julian Simmonds © Provided by The Telegraph

In 1979 Kabat-Zinn founded the Stress Reduction Clinic, devising an eight-week program of what he called Mindfulness-Based Stress Reduction (MSBR).

There, he invited medics to send him patients for whom usual medications and treatments hadn’t worked. He began to utilize the ideas around meditation together with the scientific methods in which he was trained.

It quickly proved popular and results were positive. He went on to publish various books and academic papers detailing the positive impact MSBR had on stress and the management of chronic physical pain.

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As awareness grew, medical professionals began extending the use of mindfulness to other conditions.

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“In the late Nineties we began using it in the prevention of depression,” says Mark Williams, professor of clinical psychology at Oxford University and co-author of several books on mindfulness, including the most recent, Deeper Mindfulness.

“We found it helped people to step back and observe their own negative thoughts and bring them under control. Through daily mindful meditations you can actually train your brain to notice the onset of these thoughts and observe them as they come and go without allowing them to spiral into something deeper.”

Mindfulness-based cognitive therapy (MBCT) was evaluated and trialed in the UK as a preventive measure against depression and first included in the National Institute of Health and Care Excellence guidelines in 2004.

Today, MBCT is included in the guidelines as a means of managing various types of chronic pain, tinnitus, multiple sclerosis, and more.

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Numerous studies have proved it to be effective in helping address mental health problems in the workplace, at universities, and in schools.

“I use elements of mindfulness with a wide range of patients affected by neurological conditions, such as acquired brain injuries, epilepsy, multiple sclerosis, and Parkinson’s,” says Dr. Nicolò Zarotti, a clinical psychologist at the Manchester Centre for Clinical Neurosciences and honorary clinical lecturer at Lancaster University.

“It helps facilitate their psychological adjustment to living with a life-changing condition, boost resilience and enhance acceptance.”

MBCT can help treat chronic pain, tinnitus, multiple sclerosis. and more - JLco - Julia Amaral/iStockphoto © Provided by The Telegraph 

So how does it actually work? Prof/ Mark Williams prescribes a program of mindful meditations designed to help patients focus their thought patterns.

“We start with something called a body scan, where you are encouraged to focus attention like a spotlight on the body, starting with the feet and then moving on to other parts,” he says.

“It helps to control attention. Depression is very distracting; it pulls the mind in various directions. Learning to put all of your attention in one place helps prevent that.”

Next, he encourages exercises that focus on breathing techniques. “Modern neuroscience has found that mindful breathing techniques help regulate your nervous system and actually uncouple the parts of the brain that focus on the body and the parts that are involved in overthinking and rumination.”

This process is known as “decentering.”

“It’s not about suppressing negative thoughts,” says Prof. Williams. “It’s about noticing them but not getting completely entangled in them. You give your brain something else to do other than worrying and ruminating.”

It is a robust and often challenging process. “From my own personal experience, it can be tough because it sometimes forces you to really identify and acknowledge your most negative thoughts and feelings,” says Angie Ward.

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“But the idea is to befriend them. We all have an in-built negativity bias that encourages us to look out for threats that aren’t always there. If people learn to observe their thoughts within their practice regularly, the science shows we can actually change our neural pathways, becoming more resilient to negative thinking.” This is called neuroplasticity.

Studies have shown MBCT to be as effective in the treatment of depression and anxiety as both antidepressants (such as SSRIs) and cognitive behavioral therapy.

“The problem with an antidepressant is that when people eventually decide to come off it, they tend to relapse into depression,” says Prof. Williams, “whereas mindfulness equips you with the tools you need to cope with mental health problems whenever they arise.”

Mindfulness groups are one of the most common forms of practice. More: Continued in Part 2

• The drug-free prescription for stress, depression, anxiety, and pain: Have you tried it?
• VIDEO: When I try to be Zen (comical)
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• 8 physical ways to diffuse anxiety when breathing won't work
• The Telegraph via MSN.com; Amber Larson, CC Liu (eds.), Wisdom Quarterly